Apnea-Specific Pulse-Rate Response is Associated With Early Subclinical Atherosclerosis in Obstructive Sleep Apnea

Area of Science:

• Cardiology
• Sleep Medicine
• Vascular Biology

Background:

• Obstructive sleep apnea (OSA) is linked to cardiovascular diseases (CVD).
• Novel metrics like hypoxic burden (HB) and sleep apnea-specific pulse-rate response (ΔHR) may offer better CVD correlation than the apnea-hypopnea index (AHI).
• Subclinical atherosclerosis is an early indicator of CVD.

Purpose of the Study:

• To assess the correlation between ΔHR and HB with subclinical atherosclerosis in OSA patients.
• To test if elevated ΔHR and HB are associated with subclinical atherosclerosis development.
• To investigate ΔHR and HB as potential biomarkers for CVD risk in OSA.

Main Methods:

• Prospective study of 296 individuals (20-65 years) with suspected OSA.
• Participants were categorized as OSA (AHI≥5) or healthy controls.
• Bilateral carotid ultrasonography assessed common carotid intima-media thickness (CIMT) and atheromatous plaques; ΔHR and HB derived from pulse oximetry.

Main Results:

• Higher ΔHR, but not HB, was associated with increased CIMT (p=0.006) after controlling for confounders.
• Increased time spent with oxygen saturation below 90% (T90) correlated with carotid atheroma plaques (p=0.032).
• In the second HB tertile, higher ΔHR was linked to larger CIMT (p=0.017).

Conclusions:

• Elevated ΔHR is associated with increased CIMT in adult OSA patients.
• ΔHR may serve as a potential biomarker for CVD risk in OSA.
• Further research into ΔHR's role in OSA-related cardiovascular complications is warranted.