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Obstructive sleep apnoea syndrome and endothelial function: potential impact of different treatment strategies—meta-analysis of prospective studies

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Abstract

Purpose

Previous studies have shown an association between obstructive sleep apnoea syndrome (OSAS) and cardiovascular events. Whether this association is mediated by an impairment of endothelial function, which is itself a driver of elevated cardiovascular risk, has yet to be clarified, as it is the eventual protective role of several OSAS treatments. The aim of our meta-analysis is to evaluate the effect of various OSAS treatments on endothelial function calculated by means of flow-mediated dilatation (FMD).

Methods

We conducted a meta-analysis of prospective studies including patients affected by mild to severe OSAS treated with continuous positive airway pressure (CPAP), surgery, oral appliance and medical treatments. FMD was measured before and after treatment

Results

After pooling results from different treatment strategies, OSAS treatment showed a positive impact on endothelial function (Mean Difference [MD] = 2.58; 95% CI 1.95–3.20; p < 0.00001).

Conclusions

Our study supports the hypothesis that several modalities of treatment for OSAS positively impact endothelial function. Whether this effect also associates with an improvement of clinical outcomes remains to be ascertained.

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Abbreviations

OSAS:

Obstructive sleep apnoea syndrome

CPAP:

Continuous positive airway pressure

FMD:

Flow-mediated dilatation

PRISMA:

Systematic Reviews and Meta-analyses (PRISMA) Statement

MOOSE:

Meta-analysis of Observational Studies in Epidemiology

ENT:

Ear–nose–throat

MAD:

Mandibular advancement device

RCT:

Randomized clinical trials

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Funding

No funding was received for this research.

Author information

Authors and Affiliations

  1. Department of Otolaryngology, University of Messina, Messina, Italy

    Giovanni Cammaroto & Francesco Galletti

  2. Department of Otolaryngology, Hospital Morgagni Pierantoni, Forlì, Italy

    Giovanni Cammaroto, Claudio Vicini & Filippo Montevecchi

  3. Institut Clinic Cardiovascular, Hospital Clinic, Institut D’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), IDIBAPS, University of Barcelona, Barcelona, Spain

    Francesco Costa

  4. Department of Clinical and Experimental Medicine, Policlinic “G. Martino”, University of Messina, Messina, Italy

    Francesco Costa & Giuseppe Andò

  5. Área del Corazón, Hospital Universitario Virgen de La Victoria, Campus Teatinos s/n, 29010, Málaga, Spain

    Maria Victoria Garcia Ruiz

  6. Department of Anaesthesiology, University of Messina, Messina, Italy

    Claudio Galletti

  7. Swiss Cardiovascular Center Bern, Bern University Hospital, Bern, Switzerland

    Marco Valgimigli

Authors
  1. Giovanni Cammaroto
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  2. Francesco Costa
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  3. Maria Victoria Garcia Ruiz
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  4. Giuseppe Andò
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  5. Claudio Vicini
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  6. Filippo Montevecchi
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  7. Claudio Galletti
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  8. Francesco Galletti
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  9. Marco Valgimigli
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Corresponding author

Correspondence to Giovanni Cammaroto.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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This article is part of the Topical Collection on sleep apnea syndrome.

Guest Editors: Manuele Casale, Rinaldi Vittorio.

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Cammaroto, G., Costa, F., Ruiz, M.V.G. et al. Obstructive sleep apnoea syndrome and endothelial function: potential impact of different treatment strategies—meta-analysis of prospective studies. Eur Arch Otorhinolaryngol 276, 2331–2338 (2019). https://doi.org/10.1007/s00405-019-05486-6

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  • DOI: https://doi.org/10.1007/s00405-019-05486-6

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