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Tomohiro Handa - One of the best experts on this subject based on the ideXlab platform.
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association between endothelial function assessed on reactive hyperemia Peripheral Arterial Tonometry and obstructive sleep apnea visceral fat accumulation and serum adiponectin
Circulation, 2015Co-Authors: Masanori Azuma, Takeshi Matsumoto, Yuichi Chihara, Chikara Yoshimura, Kimihiko Murase, Satoshi Hamada, Ryo Tachikawa, Morito Inouchi, Kiminobu Tanizawa, Tomohiro HandaAbstract:BACKGROUND Visceral obesity, low adiponectin, and severe obstructive sleep apnea (OSA) are associated with cardiovascular diseases, but the interactions among these factors on endothelial dysfunction are not well known. METHODS AND RESULTS Endothelial function in 133 patients after polysomnography was evaluated as reactive hyperemia index (RHI) on reactive hyperemia Peripheral Arterial Tonometry. Visceral obesity was defined as visceral fat area ≥100 cm(2)on computed tomography. RHI was significantly correlated with apnea hypopnea index (AHI), visceral fat area, and serum adiponectin (r=-0.24, P=0.0055, r=-0.19, P=0.031, and r=0.20, P=0.019, respectively). RHI in patients with visceral obesity was significantly decreased in the presence of severe OSA (AHI ≥30; P=0.042). On multivariate regression analysis, only severe OSA remained as an independent predictive factor of RHI (P=0.024, R(2)=5.4%). RHI in patients with severe OSA (n=44) was significantly improved after 3 months of continuous positive airway pressure (CPAP) treatment (1.78±0.40 before CPAP vs. 2.00±0.53 after CPAP, P=0.013), similarly to those with AHI <30 (P=0.45). CONCLUSIONS Severe OSA, but not visceral fat area or serum adiponectin, was independently associated with endothelial function according to RHI. In addition, impaired endothelial function was reversible following 3 months of CPAP treatment.
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association between endothelial function assessed on reactive hyperemia Peripheral Arterial Tonometry and obstructive sleep apnea visceral fat accumulation and serum adiponectin
Circulation, 2015Co-Authors: Masanori Azuma, Takeshi Matsumoto, Yuichi Chihara, Chikara Yoshimura, Kimihiko Murase, Satoshi Hamada, Ryo Tachikawa, Morito Inouchi, Kiminobu Tanizawa, Tomohiro HandaAbstract:development of atherosclerosis and CVD.13–16 There are 2 major methods for investigating endothelial function non-invasively: brachial artery ultrasound flow-mediated dilation (FMD) and reactive hyperemia Peripheral Arterial Tonometry (RH-PAT). Both methods are considered to assess nitric oxide-dependent vascular function. Although FMD is dependent on operator skill and is difficult to use, RH-PAT is independent of operator skill and easy to use. It was recently shown that endothelial dysfunction evaluated on RH-PAT significantly correlated with future cardiovascular events.17 Although recent reports suggest that OSA exacerbates the cardiovascular risks attributed to obesity and metabolic syndrome (MetS),18,19 there are few reports on endothelial dysbesity, in particular visceral obesity, is an important risk factor for cardiovascular disease (CVD).1,2 An interaction between visceral fat accumulation and endothelial dysfunction has been identified.3,4 Adiponectin is one of the adipokines secreted from adipocytes and has cardiovascular protective effects and anti-inflammatory effects.5 Low adiponectin has been associated with endothelial dysfunction6 and future CVD independently of body mass index (BMI) or waist circumference (WC).7 Obstructive sleep apnea (OSA), especially severe OSA, has also been associated with CVD8–10 and endothelial dysfunction.11,12 Endothelial dysfunction results in functional and reversible changes in the Arterial wall and is considered to precede the O
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Association between endothelial function (assessed on reactive hyperemia Peripheral Arterial Tonometry) and obstructive sleep apnea, visceral fat accumulation, and serum adiponectin.
Circulation journal : official journal of the Japanese Circulation Society, 2015Co-Authors: Masanori Azuma, Takeshi Matsumoto, Yuichi Chihara, Chikara Yoshimura, Kimihiko Murase, Satoshi Hamada, Ryo Tachikawa, Morito Inouchi, Kiminobu Tanizawa, Tomohiro HandaAbstract:BACKGROUND Visceral obesity, low adiponectin, and severe obstructive sleep apnea (OSA) are associated with cardiovascular diseases, but the interactions among these factors on endothelial dysfunction are not well known. METHODS AND RESULTS Endothelial function in 133 patients after polysomnography was evaluated as reactive hyperemia index (RHI) on reactive hyperemia Peripheral Arterial Tonometry. Visceral obesity was defined as visceral fat area ≥100 cm(2)on computed tomography. RHI was significantly correlated with apnea hypopnea index (AHI), visceral fat area, and serum adiponectin (r=-0.24, P=0.0055, r=-0.19, P=0.031, and r=0.20, P=0.019, respectively). RHI in patients with visceral obesity was significantly decreased in the presence of severe OSA (AHI ≥30; P=0.042). On multivariate regression analysis, only severe OSA remained as an independent predictive factor of RHI (P=0.024, R(2)=5.4%). RHI in patients with severe OSA (n=44) was significantly improved after 3 months of continuous positive airway pressure (CPAP) treatment (1.78±0.40 before CPAP vs. 2.00±0.53 after CPAP, P=0.013), similarly to those with AHI
Masanori Azuma - One of the best experts on this subject based on the ideXlab platform.
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association between endothelial function assessed on reactive hyperemia Peripheral Arterial Tonometry and obstructive sleep apnea visceral fat accumulation and serum adiponectin
Circulation, 2015Co-Authors: Masanori Azuma, Takeshi Matsumoto, Yuichi Chihara, Chikara Yoshimura, Kimihiko Murase, Satoshi Hamada, Ryo Tachikawa, Morito Inouchi, Kiminobu Tanizawa, Tomohiro HandaAbstract:BACKGROUND Visceral obesity, low adiponectin, and severe obstructive sleep apnea (OSA) are associated with cardiovascular diseases, but the interactions among these factors on endothelial dysfunction are not well known. METHODS AND RESULTS Endothelial function in 133 patients after polysomnography was evaluated as reactive hyperemia index (RHI) on reactive hyperemia Peripheral Arterial Tonometry. Visceral obesity was defined as visceral fat area ≥100 cm(2)on computed tomography. RHI was significantly correlated with apnea hypopnea index (AHI), visceral fat area, and serum adiponectin (r=-0.24, P=0.0055, r=-0.19, P=0.031, and r=0.20, P=0.019, respectively). RHI in patients with visceral obesity was significantly decreased in the presence of severe OSA (AHI ≥30; P=0.042). On multivariate regression analysis, only severe OSA remained as an independent predictive factor of RHI (P=0.024, R(2)=5.4%). RHI in patients with severe OSA (n=44) was significantly improved after 3 months of continuous positive airway pressure (CPAP) treatment (1.78±0.40 before CPAP vs. 2.00±0.53 after CPAP, P=0.013), similarly to those with AHI <30 (P=0.45). CONCLUSIONS Severe OSA, but not visceral fat area or serum adiponectin, was independently associated with endothelial function according to RHI. In addition, impaired endothelial function was reversible following 3 months of CPAP treatment.
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association between endothelial function assessed on reactive hyperemia Peripheral Arterial Tonometry and obstructive sleep apnea visceral fat accumulation and serum adiponectin
Circulation, 2015Co-Authors: Masanori Azuma, Takeshi Matsumoto, Yuichi Chihara, Chikara Yoshimura, Kimihiko Murase, Satoshi Hamada, Ryo Tachikawa, Morito Inouchi, Kiminobu Tanizawa, Tomohiro HandaAbstract:development of atherosclerosis and CVD.13–16 There are 2 major methods for investigating endothelial function non-invasively: brachial artery ultrasound flow-mediated dilation (FMD) and reactive hyperemia Peripheral Arterial Tonometry (RH-PAT). Both methods are considered to assess nitric oxide-dependent vascular function. Although FMD is dependent on operator skill and is difficult to use, RH-PAT is independent of operator skill and easy to use. It was recently shown that endothelial dysfunction evaluated on RH-PAT significantly correlated with future cardiovascular events.17 Although recent reports suggest that OSA exacerbates the cardiovascular risks attributed to obesity and metabolic syndrome (MetS),18,19 there are few reports on endothelial dysbesity, in particular visceral obesity, is an important risk factor for cardiovascular disease (CVD).1,2 An interaction between visceral fat accumulation and endothelial dysfunction has been identified.3,4 Adiponectin is one of the adipokines secreted from adipocytes and has cardiovascular protective effects and anti-inflammatory effects.5 Low adiponectin has been associated with endothelial dysfunction6 and future CVD independently of body mass index (BMI) or waist circumference (WC).7 Obstructive sleep apnea (OSA), especially severe OSA, has also been associated with CVD8–10 and endothelial dysfunction.11,12 Endothelial dysfunction results in functional and reversible changes in the Arterial wall and is considered to precede the O
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Association between endothelial function (assessed on reactive hyperemia Peripheral Arterial Tonometry) and obstructive sleep apnea, visceral fat accumulation, and serum adiponectin.
Circulation journal : official journal of the Japanese Circulation Society, 2015Co-Authors: Masanori Azuma, Takeshi Matsumoto, Yuichi Chihara, Chikara Yoshimura, Kimihiko Murase, Satoshi Hamada, Ryo Tachikawa, Morito Inouchi, Kiminobu Tanizawa, Tomohiro HandaAbstract:BACKGROUND Visceral obesity, low adiponectin, and severe obstructive sleep apnea (OSA) are associated with cardiovascular diseases, but the interactions among these factors on endothelial dysfunction are not well known. METHODS AND RESULTS Endothelial function in 133 patients after polysomnography was evaluated as reactive hyperemia index (RHI) on reactive hyperemia Peripheral Arterial Tonometry. Visceral obesity was defined as visceral fat area ≥100 cm(2)on computed tomography. RHI was significantly correlated with apnea hypopnea index (AHI), visceral fat area, and serum adiponectin (r=-0.24, P=0.0055, r=-0.19, P=0.031, and r=0.20, P=0.019, respectively). RHI in patients with visceral obesity was significantly decreased in the presence of severe OSA (AHI ≥30; P=0.042). On multivariate regression analysis, only severe OSA remained as an independent predictive factor of RHI (P=0.024, R(2)=5.4%). RHI in patients with severe OSA (n=44) was significantly improved after 3 months of continuous positive airway pressure (CPAP) treatment (1.78±0.40 before CPAP vs. 2.00±0.53 after CPAP, P=0.013), similarly to those with AHI
Takeshi Matsumoto - One of the best experts on this subject based on the ideXlab platform.
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Reactive hyperemia-Peripheral Arterial Tonometry is useful for assessment of not only endothelial function but also stenosis of the digital artery
International Journal of Cardiology, 2018Co-Authors: Shinji Kishimoto, Masato Kajikawa, Shogo Matsui, Haruki Hashimoto, Takeshi Matsumoto, Tatsuya Maruhashi, Yumiko Iwamoto, Takayuki Hidaka, Yasuki KiharaAbstract:Abstract Background Although reactive hyperemia-Peripheral Arterial Tonometry (RH-PAT) is widely used for assessment of endothelial function, RH index (RHI) cannot be measured in some cases when pulse wave amplitude (PWA) is very low. Decrease in PWA is mainly caused by proper palmar digital artery (PPDA) stenosis. The purpose of this study was to evaluate the relationship between PWA measured by RH-PAT and stenosis of the PPDA measured by digital subtraction angiography and to evaluate the limitation of assessment of endothelial function measured by RHI in patients with PPDA stenosis. Methods We measured baseline PWA in 51 fingers including the first to third fingers of both hands in 10 patients who had PPDA stenosis and in 66 fingers that were the first fingers of both hands in 33 subjects who had no PPDA stenosis. Severe stenosis was defined as over 75% by lower percent diameter stenosis between two PPDAs in a finger. Results PWA was significantly correlated with stenosis of the digital artery ( r =−0.55; P P =0.007). Conclusions RH-PAT may be useful for assessment of not only endothelial function but also PPDA stenosis. RHI may be underestimated in patients with PPDA stenosis. We should pay attention to low baseline PWA when measuring RHI. Clinical trial registration information URL for clinical trial: http://UMIN; registration number for clinical trial: UMIN000003409.
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association between endothelial function assessed on reactive hyperemia Peripheral Arterial Tonometry and obstructive sleep apnea visceral fat accumulation and serum adiponectin
Circulation, 2015Co-Authors: Masanori Azuma, Takeshi Matsumoto, Yuichi Chihara, Chikara Yoshimura, Kimihiko Murase, Satoshi Hamada, Ryo Tachikawa, Morito Inouchi, Kiminobu Tanizawa, Tomohiro HandaAbstract:development of atherosclerosis and CVD.13–16 There are 2 major methods for investigating endothelial function non-invasively: brachial artery ultrasound flow-mediated dilation (FMD) and reactive hyperemia Peripheral Arterial Tonometry (RH-PAT). Both methods are considered to assess nitric oxide-dependent vascular function. Although FMD is dependent on operator skill and is difficult to use, RH-PAT is independent of operator skill and easy to use. It was recently shown that endothelial dysfunction evaluated on RH-PAT significantly correlated with future cardiovascular events.17 Although recent reports suggest that OSA exacerbates the cardiovascular risks attributed to obesity and metabolic syndrome (MetS),18,19 there are few reports on endothelial dysbesity, in particular visceral obesity, is an important risk factor for cardiovascular disease (CVD).1,2 An interaction between visceral fat accumulation and endothelial dysfunction has been identified.3,4 Adiponectin is one of the adipokines secreted from adipocytes and has cardiovascular protective effects and anti-inflammatory effects.5 Low adiponectin has been associated with endothelial dysfunction6 and future CVD independently of body mass index (BMI) or waist circumference (WC).7 Obstructive sleep apnea (OSA), especially severe OSA, has also been associated with CVD8–10 and endothelial dysfunction.11,12 Endothelial dysfunction results in functional and reversible changes in the Arterial wall and is considered to precede the O
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association between endothelial function assessed on reactive hyperemia Peripheral Arterial Tonometry and obstructive sleep apnea visceral fat accumulation and serum adiponectin
Circulation, 2015Co-Authors: Masanori Azuma, Takeshi Matsumoto, Yuichi Chihara, Chikara Yoshimura, Kimihiko Murase, Satoshi Hamada, Ryo Tachikawa, Morito Inouchi, Kiminobu Tanizawa, Tomohiro HandaAbstract:BACKGROUND Visceral obesity, low adiponectin, and severe obstructive sleep apnea (OSA) are associated with cardiovascular diseases, but the interactions among these factors on endothelial dysfunction are not well known. METHODS AND RESULTS Endothelial function in 133 patients after polysomnography was evaluated as reactive hyperemia index (RHI) on reactive hyperemia Peripheral Arterial Tonometry. Visceral obesity was defined as visceral fat area ≥100 cm(2)on computed tomography. RHI was significantly correlated with apnea hypopnea index (AHI), visceral fat area, and serum adiponectin (r=-0.24, P=0.0055, r=-0.19, P=0.031, and r=0.20, P=0.019, respectively). RHI in patients with visceral obesity was significantly decreased in the presence of severe OSA (AHI ≥30; P=0.042). On multivariate regression analysis, only severe OSA remained as an independent predictive factor of RHI (P=0.024, R(2)=5.4%). RHI in patients with severe OSA (n=44) was significantly improved after 3 months of continuous positive airway pressure (CPAP) treatment (1.78±0.40 before CPAP vs. 2.00±0.53 after CPAP, P=0.013), similarly to those with AHI <30 (P=0.45). CONCLUSIONS Severe OSA, but not visceral fat area or serum adiponectin, was independently associated with endothelial function according to RHI. In addition, impaired endothelial function was reversible following 3 months of CPAP treatment.
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Association between endothelial function (assessed on reactive hyperemia Peripheral Arterial Tonometry) and obstructive sleep apnea, visceral fat accumulation, and serum adiponectin.
Circulation journal : official journal of the Japanese Circulation Society, 2015Co-Authors: Masanori Azuma, Takeshi Matsumoto, Yuichi Chihara, Chikara Yoshimura, Kimihiko Murase, Satoshi Hamada, Ryo Tachikawa, Morito Inouchi, Kiminobu Tanizawa, Tomohiro HandaAbstract:BACKGROUND Visceral obesity, low adiponectin, and severe obstructive sleep apnea (OSA) are associated with cardiovascular diseases, but the interactions among these factors on endothelial dysfunction are not well known. METHODS AND RESULTS Endothelial function in 133 patients after polysomnography was evaluated as reactive hyperemia index (RHI) on reactive hyperemia Peripheral Arterial Tonometry. Visceral obesity was defined as visceral fat area ≥100 cm(2)on computed tomography. RHI was significantly correlated with apnea hypopnea index (AHI), visceral fat area, and serum adiponectin (r=-0.24, P=0.0055, r=-0.19, P=0.031, and r=0.20, P=0.019, respectively). RHI in patients with visceral obesity was significantly decreased in the presence of severe OSA (AHI ≥30; P=0.042). On multivariate regression analysis, only severe OSA remained as an independent predictive factor of RHI (P=0.024, R(2)=5.4%). RHI in patients with severe OSA (n=44) was significantly improved after 3 months of continuous positive airway pressure (CPAP) treatment (1.78±0.40 before CPAP vs. 2.00±0.53 after CPAP, P=0.013), similarly to those with AHI
Cyril W.c. Kendall - One of the best experts on this subject based on the ideXlab platform.
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Test–retest reliability of Peripheral Arterial Tonometry in the metabolic syndrome
Diabetes & vascular disease research, 2014Co-Authors: Katherine A. Sauder, Sheila G. West, Cindy E. Mccrea, Janice Campbell, Alexandra L. Jenkins, David J.a. Jenkins, Cyril W.c. KendallAbstract:Endothelial dysfunction is an important contributor to atherosclerosis and cardiovascular disease. However, routine assessment via angiography or flow-mediated dilation is difficult due to technical limitations. Peripheral Arterial Tonometry (PAT) is a promising alternative method for non-invasive assessment of endothelial dysfunction. This study assessed the test-retest reliability of PAT in adults with the metabolic syndrome (n = 20) and provides sample size and power estimates for study design. Participants completed five PAT tests each separated by 1 week. The PAT-derived reactive hyperaemia index (RHI) showed robust repeatability (intra-class correlation = 0.74). A parallel-arm study powered at 0.90 would require 22 participants to detect an absolute change in RHI of 0.40 units (equal to ~25% change in this sample), whereas a crossover study would require 12 participants. In conclusion, we have demonstrated that PAT can be used to assess endothelial dysfunction in adults with the metabolic syndrome as reliably as in healthy samples.
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test retest reliability of Peripheral Arterial Tonometry in the metabolic syndrome
Diabetes and Vascular Disease Research, 2014Co-Authors: Katherine A. Sauder, Sheila G. West, Cindy E. Mccrea, Janice Campbell, Alexandra L. Jenkins, David J.a. Jenkins, Cyril W.c. KendallAbstract:Endothelial dysfunction is an important contributor to atherosclerosis and cardiovascular disease. However, routine assessment via angiography or flow-mediated dilation is difficult due to technical limitations. Peripheral Arterial Tonometry (PAT) is a promising alternative method for non-invasive assessment of endothelial dysfunction. This study assessed the test-retest reliability of PAT in adults with the metabolic syndrome (n = 20) and provides sample size and power estimates for study design. Participants completed five PAT tests each separated by 1 week. The PAT-derived reactive hyperaemia index (RHI) showed robust repeatability (intra-class correlation = 0.74). A parallel-arm study powered at 0.90 would require 22 participants to detect an absolute change in RHI of 0.40 units (equal to ~25% change in this sample), whereas a crossover study would require 12 participants. In conclusion, we have demonstrated that PAT can be used to assess endothelial dysfunction in adults with the metabolic syndrome as reliably as in healthy samples.
Yuichi Chihara - One of the best experts on this subject based on the ideXlab platform.
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association between endothelial function assessed on reactive hyperemia Peripheral Arterial Tonometry and obstructive sleep apnea visceral fat accumulation and serum adiponectin
Circulation, 2015Co-Authors: Masanori Azuma, Takeshi Matsumoto, Yuichi Chihara, Chikara Yoshimura, Kimihiko Murase, Satoshi Hamada, Ryo Tachikawa, Morito Inouchi, Kiminobu Tanizawa, Tomohiro HandaAbstract:BACKGROUND Visceral obesity, low adiponectin, and severe obstructive sleep apnea (OSA) are associated with cardiovascular diseases, but the interactions among these factors on endothelial dysfunction are not well known. METHODS AND RESULTS Endothelial function in 133 patients after polysomnography was evaluated as reactive hyperemia index (RHI) on reactive hyperemia Peripheral Arterial Tonometry. Visceral obesity was defined as visceral fat area ≥100 cm(2)on computed tomography. RHI was significantly correlated with apnea hypopnea index (AHI), visceral fat area, and serum adiponectin (r=-0.24, P=0.0055, r=-0.19, P=0.031, and r=0.20, P=0.019, respectively). RHI in patients with visceral obesity was significantly decreased in the presence of severe OSA (AHI ≥30; P=0.042). On multivariate regression analysis, only severe OSA remained as an independent predictive factor of RHI (P=0.024, R(2)=5.4%). RHI in patients with severe OSA (n=44) was significantly improved after 3 months of continuous positive airway pressure (CPAP) treatment (1.78±0.40 before CPAP vs. 2.00±0.53 after CPAP, P=0.013), similarly to those with AHI <30 (P=0.45). CONCLUSIONS Severe OSA, but not visceral fat area or serum adiponectin, was independently associated with endothelial function according to RHI. In addition, impaired endothelial function was reversible following 3 months of CPAP treatment.
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association between endothelial function assessed on reactive hyperemia Peripheral Arterial Tonometry and obstructive sleep apnea visceral fat accumulation and serum adiponectin
Circulation, 2015Co-Authors: Masanori Azuma, Takeshi Matsumoto, Yuichi Chihara, Chikara Yoshimura, Kimihiko Murase, Satoshi Hamada, Ryo Tachikawa, Morito Inouchi, Kiminobu Tanizawa, Tomohiro HandaAbstract:development of atherosclerosis and CVD.13–16 There are 2 major methods for investigating endothelial function non-invasively: brachial artery ultrasound flow-mediated dilation (FMD) and reactive hyperemia Peripheral Arterial Tonometry (RH-PAT). Both methods are considered to assess nitric oxide-dependent vascular function. Although FMD is dependent on operator skill and is difficult to use, RH-PAT is independent of operator skill and easy to use. It was recently shown that endothelial dysfunction evaluated on RH-PAT significantly correlated with future cardiovascular events.17 Although recent reports suggest that OSA exacerbates the cardiovascular risks attributed to obesity and metabolic syndrome (MetS),18,19 there are few reports on endothelial dysbesity, in particular visceral obesity, is an important risk factor for cardiovascular disease (CVD).1,2 An interaction between visceral fat accumulation and endothelial dysfunction has been identified.3,4 Adiponectin is one of the adipokines secreted from adipocytes and has cardiovascular protective effects and anti-inflammatory effects.5 Low adiponectin has been associated with endothelial dysfunction6 and future CVD independently of body mass index (BMI) or waist circumference (WC).7 Obstructive sleep apnea (OSA), especially severe OSA, has also been associated with CVD8–10 and endothelial dysfunction.11,12 Endothelial dysfunction results in functional and reversible changes in the Arterial wall and is considered to precede the O
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Association between endothelial function (assessed on reactive hyperemia Peripheral Arterial Tonometry) and obstructive sleep apnea, visceral fat accumulation, and serum adiponectin.
Circulation journal : official journal of the Japanese Circulation Society, 2015Co-Authors: Masanori Azuma, Takeshi Matsumoto, Yuichi Chihara, Chikara Yoshimura, Kimihiko Murase, Satoshi Hamada, Ryo Tachikawa, Morito Inouchi, Kiminobu Tanizawa, Tomohiro HandaAbstract:BACKGROUND Visceral obesity, low adiponectin, and severe obstructive sleep apnea (OSA) are associated with cardiovascular diseases, but the interactions among these factors on endothelial dysfunction are not well known. METHODS AND RESULTS Endothelial function in 133 patients after polysomnography was evaluated as reactive hyperemia index (RHI) on reactive hyperemia Peripheral Arterial Tonometry. Visceral obesity was defined as visceral fat area ≥100 cm(2)on computed tomography. RHI was significantly correlated with apnea hypopnea index (AHI), visceral fat area, and serum adiponectin (r=-0.24, P=0.0055, r=-0.19, P=0.031, and r=0.20, P=0.019, respectively). RHI in patients with visceral obesity was significantly decreased in the presence of severe OSA (AHI ≥30; P=0.042). On multivariate regression analysis, only severe OSA remained as an independent predictive factor of RHI (P=0.024, R(2)=5.4%). RHI in patients with severe OSA (n=44) was significantly improved after 3 months of continuous positive airway pressure (CPAP) treatment (1.78±0.40 before CPAP vs. 2.00±0.53 after CPAP, P=0.013), similarly to those with AHI