Korean Journal of Radiology

  • 제20권4호
  • /
  • Pages.631-640
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  • 2019
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  • 1229-6929(pISSN)
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  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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Carotid Arterial Calcium Scoring Using Upper Airway Computed Tomography in Patients with Obstructive Sleep Apnea: Efficacy as a Clinical Predictor of Cerebrocardiovascular Disease

  • Jae Hoon Lee (Department of Otorhinolaryngology-Head and Neck Surgery, Dong-A University College of Medicine) ;
  • Eun-Ju Kang (Department of Radiology, Dong-A University College of Medicine) ;
  • Woo Yong Bae (Department of Otorhinolaryngology-Head and Neck Surgery, Dong-A University College of Medicine) ;
  • Jong Kuk Kim (Department of Neurology, Dong-A University College of Medicine) ;
  • Jae Hyung Choi (Department of Neurosurgery, Dong-A University College of Medicine) ;
  • Chul Hoon Kim (Department of Oral and Maxillofacial Surgery, Dong-A University College of Medicine) ;
  • Sang Joon Kim (Department of Otorhinolaryngology-Head and Neck Surgery, Dong-A University College of Medicine) ;
  • Kyoo Sang Jo (Department of Otorhinolaryngology-Head and Neck Surgery, Dong-A University College of Medicine) ;
  • Moon Sung Kim (Department of Radiology, Dong-A University College of Medicine) ;
  • Tae Kyung Koh (Department of Otorhinolaryngology-Head and Neck Surgery, St. Mary's Medical Center)
  • 투고 : 2018.08.12
  • 심사 : 2018.12.16
  • 발행 : 2019.04.01
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초록

Objective: To evaluate the value of airway computed tomography (CT) in patients with obstructive sleep apnea (OSA) as a predictor of cerebrocardiovascular disease (CCVD) clinically, by quantitatively analyzing carotid arterial calcification (CarAC). Materials and Methods: This study included 287 patients aged 40-80 years, who had undergone both polysomnography (PSG) and airway CT between March 2011 and October 2015. The carotid arterial calcium score (CarACS) was quantified using the modified Agatston method on each upper airway CT. The OSA severity was categorized as normal, mild, moderate, and severe using the PSG results. Clinical characteristics, comorbid diseases, and lipid profiles of all patients were analyzed, and the prevalence of CCVDs was investigated during the follow up period (52.2 ± 16.0 months). Results: CCVD occurred in 27 patients (9.3%) at the end of follow-up, and the CCVD-present groups showed a significantly older mean age (57.5 years vs. 54.2 years), higher prevalence of hypertension (59% vs. 34%) and CarAC (51.9% vs. 20.8%), whereas sex, other comorbid diseases, and severity of OSA were not significantly different from the CCVD-absent group. A univariate analysis showed that age, hypertension, incidence of CarAC, and CarACS were risk factors for the occurrence of CCVD events. In a multivariate analysis, the incidence of CarAC was the only independent risk factor for CCVD. Conclusion: CarAC is an independent risk factor for CCVD, whereas the severity of OSA is not a contributory risk factor in patients with OSA. Therefore, additional analysis of CarACS based on airway CT scans may be useful for predicting CCVD.

키워드

과제정보

This study was supported by research funds from Dong-A University.

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