Abstract
BackgroundObstructive sleep apnea (OSA) is linked to cardiovascular diseases (CVD). The obstructive apnea-hypopnea index (oAHI) used for diagnosing and grading OSA has limitations in predicting CVD. The present study assessed and compared the association between nocturnal hypoxemia parameters and left ventricular hypertrophy (LVH).MethodsA cross-sectional study was conducted on 187 consecutive adult outpatients diagnosed with OSA after home cardiorespiratory polygraphy. Blood pressure (BP) control was tested with ambulatory blood pressure monitoring (ABPM). A standard transthoracic cardiac ultrasound examination assessed LVH. Oximetry parameters were grouped into a single parameter (Oxy-score) using factor analysis (the higher the Oxy-score, the better nocturnal oxygenation), which was tested for association with LVH.ResultsMean age: 60±12 years. Male sex: 75%. Overweight/obese: 94%. The prevalence of arterial hypertension and LVH were 92% and 75%, respectively. The prevalence of severe OSA was 44%, with a mean oAHI of 32±19. Patients with LVH had significantly higher oAHI (34±19versus27±18, p=0.030), oxygen desaturation index (ODI) (41±23versus30±18, p=0.004), and worse oximetry parameters. Oxy-score results were independently associated with LVH (adj. OR=0.45, p=0.044). oAHI lost its independent relationship with LVH when the model included the Oxy-score. ROCs showed that oAHI was less accurate in predicting LVH than Oxy-score [AUC 0.63 (95% CI 0.59–0.68)versusAUC 0.70 (95% CI 0.65–0.74), respectively, p=0.005].ConclusionNocturnal oximetry parameters, grouped into a single parameter as a proxy of the global hypoxic burden, proved to be a better and independent predictor of LVH than oAHI, supporting the pivotal relevance of oximetry parameters in OSA patients beyond oAHI.
Published Version
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