[Prevalence of silent cerebrovascular lesions in patients with obstructive sleep apnea syndrome].

INTRODUCTION: The obstructive sleep apnea syndrome (OSA) confers increased risk of cardiovascular disease, given its association with other vascular risk factors. Both OSA and other vascular risk factors are associated with silent brain lesions.

AIM: To assess the prevalence of silent brain lesions in patients with OSA.

PATIENTS AND METHODS: We retrospectively evaluated a cohort of 137 patients with OSA. The mean age was 65 ± 12 years; 45% were women. The silent brain lesions in magnetic resonance imaging were assessed with the Visual Scale of Fazekas (FVS), and the presence of cortical infarcts, lacunar and microbleedings was assessed.

RESULTS: Vascular risk factors prevalence was: hypertension 64%, dyslipemia 58%, diabetes 18%, smoking 34%, carotid atherosclerosis 26%, coronary heart disease 13%, and atrial fibrillation 4%. OSA was mild in 47%, moderate in 31% and severe in 22% of the patients. 91% of patients had periventricular hyperintensities, and 66% showed subcortical white matter lesions. The average value of apnea/hipopnea index was higher in patients with score 2 and 3 in FVS, although without statistical significance.

CONCLUSIONS: Patients with OSA in our study have a high prevalence of silent brain lesions, mainly with microangiopathic pattern. This is possibly explained by the relation between OSA, hypertension and other vascular risk factors.