scholarly journals Effect of Heart Rate Variability on the Association Between the Apnea-Hypopnea Index and Cerebral Small Vessel Disease

Stroke ◽  
2019 ◽  
Vol 50 (9) ◽  
pp. 2486-2491 ◽  
Author(s):  
Oscar H. Del Brutto ◽  
Robertino M. Mera ◽  
Aldo F. Costa ◽  
Pablo R. Castillo
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Small Vessel ◽  
Apnea Hypopnea Index ◽  
Vessel Disease

scholarly journals Effect of obstructive sleep apnea on cerebrovascular compliance and cerebral small vessel disease

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259469
Author(s):  
Woo-Jin Lee ◽  
Keun-Hwa Jung ◽  
Hyun-Woo Nam ◽  
Yong-Seok Lee
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Confidence Interval ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Small Vessel ◽  
Apnea Hypopnea Index ◽  
Volume Number ◽  
Vessel Disease ◽  
Obstructive Sleep

Reduced cerebrovascular compliance is the major mechanism of cerebral small vessel disease (SVD). Obstructive sleep apnea (OSA) also promotes SVD development, but the underlying mechanism was not elucidated. We investigated the association among OSA, cerebrovascular compliance, and SVD parameters. This study retrospectively included individuals ≥ 50 years of age, underwent overnight polysomnographic (PSG) for the evaluation of OSA, and performed MRI and transcranial Doppler (TCD) within 12 months of interval without a neurological event between the evaluations. TCD parameters for the cerebrovascular compliance included middle cerebral artery pulsatility index (MCA PI) and mean MCA resistance index ratio (MRIR). SVD parameters included white matter hyperintensity (WMH) volume, number of lacunes, enlarged perivascular space (ePVS) score, and the presence of microbleeds or lacunes. Ninety-seven individuals (60.8% male, mean age 70.0±10.5 years) were included. MRIR was associated with higher respiratory distress index (B = 0.003; 95% confidence interval [CI] 0.001–0.005; P = 0.021), while MCA PI was not associated with any of the PSG markers for OSA severity. Apnea-hypopnea index was associated with the log-transformed total WMH volume (B = 0.008; 95% confidence interval [CI] 0.001–0.016; P = 0.020), subcortical WMH volume (B = 0.015; 95% CI 0.007–0.022; P<0.001), total ePVS score (B = 0.024; 95% CI 0.003–0.045; P = 0.026), and centrum semiovale ePVS score (B = 0.026; 95% CI 0.004–0.048; P = 0.019), and oxygen-desaturation index with periventricular WMH volume, independently from age, MCA PI, and MRIR. This study concluded that OSA is associated with reduced cerebrovascular compliance and also with SVD independently from cerebrovascular compliance. Underlying pathomechanistic link might be region specific.

scholarly journals Periodic Limb Movements Syndrome in Patients With Cerebral Small Vessel Disease: Protocol for a Prospective Observational Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Ekaterina Spektor ◽  
Ingo Fietze ◽  
Mikhail G. Poluektov
Keyword(s):  
Cognitive Decline ◽  
Small Vessel Disease ◽  
Brain Mri ◽  
Cerebral Small Vessel Disease ◽  
Small Vessel ◽  
Periodic Limb Movements ◽  
Apnea Hypopnea Index ◽  
Limb Movements ◽  
Vessel Disease

Background: Cerebrovascular diseases are the leading cause of cognitive decline and dementia. Therefore, the investigation of the potential ways to slow down the disease progression is an important research field. Periodic limb movements in sleep (PLMS) are known to be associated with transient changes in heart rate and blood pressure. These changes might influence the course of cerebral small vessel disease (cSVD). Nevertheless, the clinical significance of PLMS, particularly its influence on cardiovascular diseases course, is still controversial and underinvestigated.Methods/design: Patients from 60 to 75 years old diagnosed with cSVD will undergo nocturnal polysomnography. Subjects with apnea/hypopnea index under 5 will be enrolled. Sleep quality and daytime functioning will be assessed at baseline with self-reported questionnaires. Brain MRI and cognitive assessment will be performed at baseline and in the 2-year follow-up. Progression of cSVD markers and cognitive dysfunction will be compared between patients with PLMS index (PLMI) equal to or more than 15 movements per hour of sleep and controls (PLMI &lt;15/h).Discussion: The negative role of PLMS in cSVD progression and related cognitive decline is expected. We suppose that patients with PLMS tend to worsen in cognitive performance more rapidly than age-, gender-, and comorbidity-matched controls. We also expect them to have more rapid white matter hyperintensities and other cSVD marker progression. The limitations of the study protocol are the short follow-up period, the absence of a treatment group, and inability to make a conclusion about causality.

scholarly journals Decreased Nocturnal Heart Rate Variability and Potentially Related Brain Regions In Arteriosclerotic Cerebral Small Vessel Disease

2021 ◽  
Author(s):  
Miaoyi Zhang ◽  
Huan Yu ◽  
Weijun Tang ◽  
Ding Ding ◽  
Jie Tang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Sleep Disordered Breathing ◽  
Small Vessel Disease ◽  
Brain Regions ◽  
Cerebral Small Vessel Disease ◽  
Sleep Period ◽  
Vessel Disease ◽  
Cerebrovascular Risk

Abstract Background To assess heart rate variability(HRV) among patients with arteriosclerotic cerebral small vessel disease (CSVD) by comparing with control subjects, and to determine whether HRV parameters were related to structural alterations in brain regions involved in autonomic regulation among CSVD patients. MethodsWe consecutively recruited subjects aged between 50 and 80 years who visited the Sleep Center of Huashan Hospital from September 1, 2018 to August 31, 2019. Brain magnetic resonance imaging(MRI) was scanned before enrollment. 63 patients were assigned to the arteriosclerotic CSVD group and 46 to the control group. Polysomnography and synchronous analyses of HRV were performed. Multivariable binary logistic regression was used to identify the relationship between HRV parameters and CSVD. A number of 24 CSVD patients and 21 control participants further underwent three-dimensional brain volume scan, and the voxel based morphometry (VBM) analysis was used to identify gray matter atrophy.ResultsLower standard deviation of normal-to-normal intervals(SDNN, OR=0.943, 95% CI 0.903 to 0.985, P=0.009) and higher ratio of low to high frequency power (LF/HF, OR=4.372, 95% CI 1.033 to 18.508, P=0.045) during the sleep period were associated with CSVD, independent of traditional cerebrovascular risk factors and sleep disordered breathing. Based on VBM results, SDNN during the awake time (b=0.544, 95% CI 0.211 to 0.877, P=0.001) and the sleep period(b=0.532, 95% CI 0.202 to 0.862, P=0.001) were both positively related with gray matter thickness within the right inferior frontal gyrus only among CSVD patients.ConclusionsDecreased nocturnal HRV may be associated with arteriosclerotic CSVD independent of traditional cerebrovascular risk factors and sleep disordered breathing. The structural atrophy of some brain regions associated with cardiac autonomic regulation sheds light on the potential relationship.Trial registration Trial registration number: ChiCTR1800017902.Date of registration: 2018-08-20

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