Effect of uvulopalatopharyngoplasty (UPPP) on atherosclerosis and cardiac functioning in obstructive sleep apnea patients

Abstract

Background: Obstructive sleep apnea (OSA) is associated with several cardiovascular comorbidities including hypertension, arteriosclerosis, and heart failure. Uvulopalatopharyngoplasty (UPPP) is a frequently performed surgical treatment for OSA.

Aims/Objectives: To analyze if UPPP can improve cardiac parameters associated with atherosclerosis and reduce the cardiac burden in OSA patients.

Material and methods: A prospective cohort study was performed at a single tertiary care center where OSA patients undergoing UPPP were evaluated. Preoperative and 6-month postoperative cardiac parameters namely carotid artery intima-media thickness (CIMT), arterial stiffness parameters, echocardiography, and polysomnography (PSG) results were compared.

Results: Fifty three patients were included in the study. The success and response rate of UPPP was 60.4%. Following the surgery, significant reduction in arterial stiffness index (β) (12.4 ± 4.1 vs. 11.2 ± 4.0, p = .01), and elasticity modulus (Ep) (172.8 ± 68.3 vs. 156.6 ± 55.3, p = .05) was noticed. Additionally, echocardiographic parameters namely velocity across aortic valve (121.9 ± 22.9 vs. 109.4 ± 17.7, p = .01) and velocity across pulmonary valve (107.4 ± 16.4 vs. 94.2 ± 16.9, p < .01) significantly decreased following UPPP.

Conclusions and significance: UPPP significantly improves parameters related to carotid atherosclerosis and has the potential to reduce cardiac burden in OSA patients.

背景：阻塞性睡眠呼吸暂停（OSA）与多种心血管合并症有关, 包括高血压、动脉硬化和心力衰竭。悬雍垂腭咽成形术（UPPP）是经常进行的OSA手术治疗。

目的：分析UPPP是否可以改善与动脉粥样硬化相关的心脏参数, 并减少OSA患者的心脏负担。

材料和方法：一项前瞻性队列研究在一个三级医疗中心进行, 对接受UPPP的OSA患者进行了评估。对术前和术后6个月的心脏参数, 即颈动脉内膜中层厚度（CIMT）、动脉硬度参数、超声心动图和多导睡眠图（PSG）结果, 进行了比较。

结果：53名患者被纳入研究。 UPPP的成功率和响应率为60.4％。手术后, 动脉僵硬度指数（β）显著降低（12.4±4.1 对 11.2±4.0, p = .01）, 并注意到弹性模量（Ep）（172.8±68.3 对 156.6±55.3, p = .05）。此外, 超声心动图参数即主动脉瓣的速度（121.9±22.9对109.4±17.7, p = .01）和肺动脉瓣的速度（107.4±16.4对94.2±16.9, p <.01）在UPPP术后显著下降。

结论和意义：UPPP显著改善与颈动脉粥样硬化相关的参数, 并有可能减少OSA患者的心脏负担。

Keywords:

• Obstructive sleep apnea (OSA)
• uvulopalatopharyngoplasty (UPPP)
• polysomnography (PSG)
• carotid intima-media thickness (CIMT)
• echo-tracking (ET)
• echocardiography

Acknowledgements

The authors thank all the participants who made this study possible.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the National Natural Science Foundation of China under Grant [number 81670903]; and Beijing Municipal Administration of Hospitals Ascent Plan under Grant [number DFL20150602].