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Pulse Wave Amplitude Drops Index: A Biomarker of Cardiovascular Risk in Obstructive Sleep Apnea
RATIONALE: It is currently unclear which patients with obstructive sleep apnea (OSA) are at increased cardiovascular risk. OBJECTIVE: To investigate the value of pulse wave amplitude drops (PWADs), reflecting sympathetic activations and vasoreactivity, as a biomarker of cardiovascular risk in OSA. M...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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American Thoracic Society
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10273112/ https://www.ncbi.nlm.nih.gov/pubmed/37017487 http://dx.doi.org/10.1164/rccm.202206-1223OC |
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author | Solelhac, Geoffroy Sánchez-de-la-Torre, Manuel Blanchard, Margaux Berger, Mathieu Hirotsu, Camila Imler, Théo Sánchez-de-la-Torre, Alicia Haba-Rubio, Jose Marchi, Nicola Andrea Bayon, Virginie Bailly, Sébastien Goupil, François Waeber, Adrien Heiniger, Grégory Pigeanne, Thierry Gracia-Lavedan, Esther Zapater, Andrea Abad, Jorge Ordax, Estrella Masdeu, María José Cabriada-Nuño, Valentin Egea, Carlos Van Den Broecke, Sandra Vollenweider, Peter Marques-Vidal, Pedro Vaucher, Julien Bernardi, Giulio Betta, Monica Siclari, Francesca Barbé, Ferran Gagnadoux, Frédéric Heinzer, Raphael |
author_facet | Solelhac, Geoffroy Sánchez-de-la-Torre, Manuel Blanchard, Margaux Berger, Mathieu Hirotsu, Camila Imler, Théo Sánchez-de-la-Torre, Alicia Haba-Rubio, Jose Marchi, Nicola Andrea Bayon, Virginie Bailly, Sébastien Goupil, François Waeber, Adrien Heiniger, Grégory Pigeanne, Thierry Gracia-Lavedan, Esther Zapater, Andrea Abad, Jorge Ordax, Estrella Masdeu, María José Cabriada-Nuño, Valentin Egea, Carlos Van Den Broecke, Sandra Vollenweider, Peter Marques-Vidal, Pedro Vaucher, Julien Bernardi, Giulio Betta, Monica Siclari, Francesca Barbé, Ferran Gagnadoux, Frédéric Heinzer, Raphael |
author_sort | Solelhac, Geoffroy |
collection | PubMed |
description | RATIONALE: It is currently unclear which patients with obstructive sleep apnea (OSA) are at increased cardiovascular risk. OBJECTIVE: To investigate the value of pulse wave amplitude drops (PWADs), reflecting sympathetic activations and vasoreactivity, as a biomarker of cardiovascular risk in OSA. METHODS: PWADs were derived from pulse oximetry–based photoplethysmography signals in three prospective cohorts: HypnoLaus (N = 1,941), the Pays-de-la-Loire Sleep Cohort (PLSC; N = 6,367), and “Impact of Sleep Apnea syndrome in the evolution of Acute Coronary syndrome. Effect of intervention with CPAP” (ISAACC) (N = 692). The PWAD index was the number of PWADs (>30%) per hour during sleep. All participants were divided into subgroups according to the presence or absence of OSA (defined as ⩾15 or more events per hour or <15/h, respectively, on the apnea–hypopnea index) and the median PWAD index. Primary outcome was the incidence of composite cardiovascular events. MEASUREMENTS AND MAIN RESULTS: Using Cox models adjusted for cardiovascular risk factors (hazard ratio; HR [95% confidence interval]), patients with a low PWAD index and OSA had a higher incidence of cardiovascular events compared with the high-PWAD and OSA group and those without OSA in the HypnoLaus cohort (HR, 2.16 [1.07–4.34], P = 0.031; and 2.35 [1.12–4.93], P = 0.024) and in the PLSC (1.36 [1.13–1.63], P = 0.001; and 1.44 [1.06–1.94], P = 0.019), respectively. In the ISAACC cohort, the low-PWAD and OSA untreated group had a higher cardiovascular event recurrence rate than that of the no-OSA group (2.03 [1.08–3.81], P = 0.028). In the PLSC and HypnoLaus cohorts, every increase of 10 events per hour in the continuous PWAD index was negatively associated with incident cardiovascular events exclusively in patients with OSA (HR, 0.85 [0.73–0.99], P = 0.031; and HR, 0.91 [0.86–0.96], P < 0.001, respectively). This association was not significant in the no-OSA group and the ISAACC cohort. CONCLUSIONS: In patients with OSA, a low PWAD index reflecting poor autonomic and vascular reactivity was independently associated with a higher cardiovascular risk. |
format | Online Article Text |
id | pubmed-10273112 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | American Thoracic Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-102731122023-06-17 Pulse Wave Amplitude Drops Index: A Biomarker of Cardiovascular Risk in Obstructive Sleep Apnea Solelhac, Geoffroy Sánchez-de-la-Torre, Manuel Blanchard, Margaux Berger, Mathieu Hirotsu, Camila Imler, Théo Sánchez-de-la-Torre, Alicia Haba-Rubio, Jose Marchi, Nicola Andrea Bayon, Virginie Bailly, Sébastien Goupil, François Waeber, Adrien Heiniger, Grégory Pigeanne, Thierry Gracia-Lavedan, Esther Zapater, Andrea Abad, Jorge Ordax, Estrella Masdeu, María José Cabriada-Nuño, Valentin Egea, Carlos Van Den Broecke, Sandra Vollenweider, Peter Marques-Vidal, Pedro Vaucher, Julien Bernardi, Giulio Betta, Monica Siclari, Francesca Barbé, Ferran Gagnadoux, Frédéric Heinzer, Raphael Am J Respir Crit Care Med Original Articles RATIONALE: It is currently unclear which patients with obstructive sleep apnea (OSA) are at increased cardiovascular risk. OBJECTIVE: To investigate the value of pulse wave amplitude drops (PWADs), reflecting sympathetic activations and vasoreactivity, as a biomarker of cardiovascular risk in OSA. METHODS: PWADs were derived from pulse oximetry–based photoplethysmography signals in three prospective cohorts: HypnoLaus (N = 1,941), the Pays-de-la-Loire Sleep Cohort (PLSC; N = 6,367), and “Impact of Sleep Apnea syndrome in the evolution of Acute Coronary syndrome. Effect of intervention with CPAP” (ISAACC) (N = 692). The PWAD index was the number of PWADs (>30%) per hour during sleep. All participants were divided into subgroups according to the presence or absence of OSA (defined as ⩾15 or more events per hour or <15/h, respectively, on the apnea–hypopnea index) and the median PWAD index. Primary outcome was the incidence of composite cardiovascular events. MEASUREMENTS AND MAIN RESULTS: Using Cox models adjusted for cardiovascular risk factors (hazard ratio; HR [95% confidence interval]), patients with a low PWAD index and OSA had a higher incidence of cardiovascular events compared with the high-PWAD and OSA group and those without OSA in the HypnoLaus cohort (HR, 2.16 [1.07–4.34], P = 0.031; and 2.35 [1.12–4.93], P = 0.024) and in the PLSC (1.36 [1.13–1.63], P = 0.001; and 1.44 [1.06–1.94], P = 0.019), respectively. In the ISAACC cohort, the low-PWAD and OSA untreated group had a higher cardiovascular event recurrence rate than that of the no-OSA group (2.03 [1.08–3.81], P = 0.028). In the PLSC and HypnoLaus cohorts, every increase of 10 events per hour in the continuous PWAD index was negatively associated with incident cardiovascular events exclusively in patients with OSA (HR, 0.85 [0.73–0.99], P = 0.031; and HR, 0.91 [0.86–0.96], P < 0.001, respectively). This association was not significant in the no-OSA group and the ISAACC cohort. CONCLUSIONS: In patients with OSA, a low PWAD index reflecting poor autonomic and vascular reactivity was independently associated with a higher cardiovascular risk. American Thoracic Society 2023-04-05 /pmc/articles/PMC10273112/ /pubmed/37017487 http://dx.doi.org/10.1164/rccm.202206-1223OC Text en Copyright © 2023 by the American Thoracic Society https://creativecommons.org/licenses/by-nc-nd/4.0/This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . For commercial usage and reprints, please e-mail Diane Gern (dgern@thoracic.org). |
spellingShingle | Original Articles Solelhac, Geoffroy Sánchez-de-la-Torre, Manuel Blanchard, Margaux Berger, Mathieu Hirotsu, Camila Imler, Théo Sánchez-de-la-Torre, Alicia Haba-Rubio, Jose Marchi, Nicola Andrea Bayon, Virginie Bailly, Sébastien Goupil, François Waeber, Adrien Heiniger, Grégory Pigeanne, Thierry Gracia-Lavedan, Esther Zapater, Andrea Abad, Jorge Ordax, Estrella Masdeu, María José Cabriada-Nuño, Valentin Egea, Carlos Van Den Broecke, Sandra Vollenweider, Peter Marques-Vidal, Pedro Vaucher, Julien Bernardi, Giulio Betta, Monica Siclari, Francesca Barbé, Ferran Gagnadoux, Frédéric Heinzer, Raphael Pulse Wave Amplitude Drops Index: A Biomarker of Cardiovascular Risk in Obstructive Sleep Apnea |
title | Pulse Wave Amplitude Drops Index: A Biomarker of Cardiovascular Risk in Obstructive Sleep Apnea |
title_full | Pulse Wave Amplitude Drops Index: A Biomarker of Cardiovascular Risk in Obstructive Sleep Apnea |
title_fullStr | Pulse Wave Amplitude Drops Index: A Biomarker of Cardiovascular Risk in Obstructive Sleep Apnea |
title_full_unstemmed | Pulse Wave Amplitude Drops Index: A Biomarker of Cardiovascular Risk in Obstructive Sleep Apnea |
title_short | Pulse Wave Amplitude Drops Index: A Biomarker of Cardiovascular Risk in Obstructive Sleep Apnea |
title_sort | pulse wave amplitude drops index: a biomarker of cardiovascular risk in obstructive sleep apnea |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10273112/ https://www.ncbi.nlm.nih.gov/pubmed/37017487 http://dx.doi.org/10.1164/rccm.202206-1223OC |
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