Altered clot microstructure detected in obstructive sleep apnoea hypopnoea syndrome

Lindsay D’Silva, Maria Wilczynska, Keir Lewis, Matthew Lawrence, Karl Hawkins, Rhodri Williams, Sophia Stanford, Simon Davidson, Keith Morris, Adrian Evans*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Abnormal clot microstructure plays a pivotal role in the pathophysiology of thromboem­bolic diseases. Assessing the viscoelastic properties of clot microstructure using novel parameters, Time to Gel Point (TGP), Fractal Dimension (df) and clot elasticity (G'GP) could explain the increased cardiovascular and thromboembolic events in patients with Obstructive Sleep Apnoea Hypopnea Syndrome (OSAHS). We wanted to compare TGP, df, and G'gp and their diurnal variation in OSAHS and symptomatic comparators. thirty six patients attending a sleep disturbed breathing clinic with symptoms of OSAHS were recruited. TGP, df and G'gp were measured alongside standard coagulation screening, thrombin generation assays, and platelet aggregometry at 16:00 h and immediately after an in-patient sleep study at 07:30 h. OSAHS group had significantly lower afternoon df than comparators (1.705+0.033 vs. 1.731 + 0.031, p<0.05). df showed diurnal variation and only in the OSAHS group, being significantly lower in the afternoon than morning (p<0. 05). Diurnal changes in df correlated with 4% DR, even after controlling for BMI (r=0.37, p=0.02). The lower df in the afternoon in OSAHS suggests a partial compensatory change that may make up for other pro-clotting abnormalities/hypertension during the night. The change to the thrombotic tendency in the afternoon is biggest in severe OSAHS. df Shows promise as a new microstructural indicator for abnormal haemostasis in OSAHS.

Original languageEnglish
Pages (from-to)14-19
Number of pages6
JournalSleep Science
Volume9
Issue number1
DOIs
Publication statusPublished - 23 Feb 2016

Keywords

  • Clot elasticity G'
  • Clot microstructure
  • Coagulation
  • Fractal dimension
  • Gel time
  • Sleep apnoea

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