Abstract
BackgroundObstructive sleep apnea (OSA) is highly prevalent in patients with hypertrophic obstructive cardiomyopathy (HOCM). Inflammatory responses are increased in patients with OSA, meanwhile, inflammation is also associated with adverse outcomes in HOCM.HypothesisTo investigate the association between severity of OSA and high‐sensitivity C‐reactive protein (hs‐CRP) in patients with HOCM.MethodsThree hundred and ninteen patients with HOCM who underwent sleep evaluations at Fuwai Hospital were retrospectively included between February 2010 and December 2018. Data from baseline clinical characteristics and polysomnography studies were collected.ResultsOSA was present in 168 (52.7%). Patients with OSA were older, more likely to be male, had a higher body mass index and more clinical comorbidities. Patients with OSA had enlarged left ventricular diameter and similar left ventricular outflow tract obstruction compared with those without. In multivariate logistic analysis, apnea‐hypopnea index (OR, 1.024; 95% CI, 1.005‐1.044; P = .014), oxygen desaturation index (OR, 1.025; 95% CI, 1.004‐1.046; P = .018) and lowest oxygen saturation (OR, 0.951; 95% CI, 0.915‐0.989; P = .011) were independently associated with high risk hs‐CRP (>3 mg/L) after adjusting for confounders. In addition, decreasing lowest oxygen saturation (β = −.159, P = .004) was also independently correlated with increasing hs‐CRP concentrations in multivariate linear analysis after adjusting for confounders.ConclusionsSeverity of OSA was independently associated with elevated hs‐CRP levels in patients with HOCM. Further studies are needed to evaluate the effects of treating OSA on hs‐CRP as well as clinical outcomes in these patients.
Highlights
Considering that Obstructive sleep apnea (OSA) is highly prevalent in patients with Hypertrophic cardiomyopathy (HCM) ranging from 32% to 71%,14,15 we propose that OSA be associated with elevated inflammation in HCM
This study showed that OSA was highly prevalent (52.7%) in this large hypertrophic obstructive cardiomyopathy (HOCM) population
Decreasing lowest SaO2 independently correlated with increasing high-sensitivity C-reactive protein (hs-CRP) concentrations in multivariate linear analysis
Summary
Obstructive sleep apnea (OSA), characterized by oxygen desaturation and sleep fragmentation due to apneas and hypopneas during sleep, has been increasingly implicated in the pathogenesis and complications of cardiovascular disease.[1,2] Elevated systemic inflammation is seen in patients with OSA because of long-term hypoxia, sympathetic activation, and oxidative stress.[3,4] In addition, treatment of OSA significantly reduces the inflammatory responses indicating an important role of inflammation in the pathophysiological processes of OSA.[5,6,7]. The association of OSA with hs-CRP in patients with HOCM, a more serious type of HCM, was investigated in this study
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