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Title of Journal: Sleep Breath

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Abbravation: Sleep and Breathing

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Springer-Verlag

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DOI

10.1007/bf01426915

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1522-1709

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Hemostatic implications of endothelial cell apopto

Authors: Ali A El Solh Morohunfolu E Akinnusi Ilya G Berim A Misha Peter Linda L Paasch Kristie R Szarpa
Publish Date: 2008/04/09
Volume: 12, Issue: 4, Pages: 331-337
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Abstract

Patients with obstructive sleep apnea OSA are at increased risk of atherothrombosis independent of the Framingham risk factors Studies on hemostasis factors in OSA are scarce and inconsistent We sought to understand the variation in atherothrombotic propensity as a function of apoptotic circulating endothelial cells CECs in OSA by investigating the relationship between CEC apoptosis and plasma levels of hemostatic factors tissue factor TF and von Willebrand Factor vWF in apneic subjects Apoptotic CECs were detected by flow cytometry in 35 male subjects free of cardiovascular diseases AHI range 8–43 and 12 healthy male controls AHI range 2–5 before and after 8 weeks of nasal continuous positive airway pressure nCPAP Quantitative determination of TF and vWF was performed using an enzymelinked immunosorbent assay ELISA kit The mean levels of TF 6678 ± 4159 pg/ml and vWF 18970 ± 6924 IU/dl were significantly higher in OSA patients compared with those in healthy subjects 4283 ± 1418 pg/ml and 12448 ± 3143 IU/dl Apoptotic CECs were elevated in patients with OSA and correlated strongly with TF and vWF levels p = 002 and p  0001 respectively There were no correlations between TF vWF and apnea hypopnea index or arousal index Only the percentage of time spent 90 oxygen saturation was inversely associated with TF r = 038 p = 002 Following nCPAP therapy there was significant decrease in TF levels that correlated with decrease in apoptotic CECs In patients with OSA increased prothrombotic factors are strongly determined by apoptotic CECs Treatment with nCPAP may alleviate the coagulation propensity

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