Pulse Wave Amplitude Drops Index : A Biomarker of Cardiovascular Risk in Obstructive Sleep Apnea
Solelhac, Geoffroy (Center for Investigation and Research in Sleep)
Sánchez-de-la-Torre, Manuel (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Blanchard, Margaux (Laboratoire d'Acoustique de l'Université du Mans)
Berger, Mathieu (Center for Investigation and Research in Sleep)
Hirotsu, Camila (Center for Investigation and Research in Sleep)
Imler, Théo (Center for Investigation and Research in Sleep)
Sánchez-de-la-Torre, Alicia (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Haba-Rubio, José (Center for Investigation and Research in Sleep)
Marchi, Nicola Andrea (Center for Investigation and Research in Sleep)
Bayon, Virginie (Center for Investigation and Research in Sleep)
Bailly, Sébastien (Université Grenoble Alpes)
Goupil, François (Le Mans General Hospital)
Waeber, Adrien (Center for Investigation and Research in Sleep)
Heiniger, Grégory (Center for Investigation and Research in Sleep)
Pigeanne, Thierry (Pôle santé des Olonnes)
Gracia-Lavedan, Esther (Hospital Universitari Arnau de Vilanova and Santa Maria)
Zapater, Andrea (Universitat de Lleida)
Abad Capa, Jorge (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Ordax, Estrella (Hospital Universitario de Burgos)
Masdeu, María José (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Cabriada-Nuño, Valentín (Hospital Universitario de Cruces (Barakaldo, País Basc))
Egea, Carlos J (Instituto de Investigación Sanitaria Bioaraba (Vitoria, País Basc))
Van Den Broecke, Sandra (Hôpital Neuchâtelois)
Vollenweider, Peter (Internal Medicine)
Marques-Vidal, Pedro (University of Lausanne)
Vaucher, Julien (Internal Medicine)
Bernardi, Giulio (IMT School for Advanced Studies)
Betta, Monica (IMT School for Advanced Studies)
Siclari, Francesca (The Sense Innovation and Research Center)
Barbé, Ferran (Hospital Universitari Arnau de Vilanova and Santa Maria)
Gagnadoux, Frédéric (University of Angers)
Heinzer, Raphael (Lausanne University Hospital)
Universitat Autònoma de Barcelona

Fecha:	2023
Resumen:	It is currently unclear which patients with obstructive sleep apnea (OSA) are at increased cardiovascular risk. To investigate the value of pulse wave amplitude drops (PWADs), reflecting sympathetic activations and vasoreactivity, as a biomarker of cardiovascular risk in OSA. 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. 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. In patients with OSA, a low PWAD index reflecting poor autonomic and vascular reactivity was independently associated with a higher cardiovascular risk.
Ayudas:	Instituto de Salud Carlos III PI18/00449 Instituto de Salud Carlos III PI19/00907
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Cardiovascular risk ; Pulse oximeter ; Pulse wave amplitude ; PWAD ; Sleep apnea
Publicado en:	American Journal of Respiratory and Critical Care Medicine, Vol. 207 (april 2023) , p. 1620-1632, ISSN 1535-4970

DOI: 10.1164/rccm.202206-1223OC
PMID: 37017487

13 p, 1.3 MB

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Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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