Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Thoracic Society 2023
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
_version_ 1785059633580212224
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
work_keys_str_mv AT solelhacgeoffroy pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT sanchezdelatorremanuel pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT blanchardmargaux pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT bergermathieu pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT hirotsucamila pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT imlertheo pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT sanchezdelatorrealicia pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT habarubiojose pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT marchinicolaandrea pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT bayonvirginie pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT baillysebastien pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT goupilfrancois pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT waeberadrien pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT heinigergregory pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT pigeannethierry pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT gracialavedanesther pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT zapaterandrea pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT abadjorge pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT ordaxestrella pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT masdeumariajose pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT cabriadanunovalentin pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT egeacarlos pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT vandenbroeckesandra pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT vollenweiderpeter pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT marquesvidalpedro pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT vaucherjulien pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT bernardigiulio pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT bettamonica pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT siclarifrancesca pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT barbeferran pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT gagnadouxfrederic pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea
AT heinzerraphael pulsewaveamplitudedropsindexabiomarkerofcardiovascularriskinobstructivesleepapnea