Obstructive sleep apnea is associated with coronary microvascular dysfunction: A systematic review from a clinical...

Area of Science:

• Cardiology
• Sleep Medicine
• Vascular Biology

Background:

• Obstructive sleep apnea (OSA) is increasingly recognized for its role in microvascular disorders.
• The association between OSA and impaired coronary flow reserve (CFR) remains incompletely understood.

Purpose of the Study:

• To systematically review and meta-analyze existing evidence on the relationship between OSA and CFR.
• To determine if OSA is associated with coronary microvascular dysfunction (CMD).

Main Methods:

• A systematic search of PubMed, Embase, Cochrane Library, and Web of Science was conducted.
• Five observational studies involving 829 OSA patients and 507 non-OSA subjects were included.
• Random-effects modeling was used for meta-analysis of coronary flow reserve (CFR) data.

Main Results:

• OSA was significantly associated with reduced CFR across all included studies (WMD -0.78, 95% CI -1.25 to -0.32).
• Meta-regression indicated that the apnea-hypopnea index (AHI) explained significant heterogeneity, suggesting CFR negatively correlates with OSA severity.
• No significant publication bias was detected via Egger's regression test.

Conclusions:

• The findings support plausible biological links between OSA and coronary microvascular dysfunction (CMD).
• Evidence strongly suggests OSA, especially severe OSA, is associated with reduced CFR.
• Further prospective studies are needed to clarify OSA's precise role in CMD development.