Circulating Microparticles in Patients with Obstructive Sleep Apnea and Cardiovascular Comorbidities

Introduction: Obstructive sleep apnea (OSA) is associated with increased rates of atrial fibrillation (AF). Recent randomized data suggest that traditional scoring of OSA needs to evolve to improve cardiovascular outcomes. Traditional scoring of OSA does not fully reflect pathophysiological links between OSA and AF, particularly regarding OSA-induced prolongation of p-wave duration (PWD), which is the most powerful predictor of AF occurrence. Hypothesis: We hypothesized that OSA episodes that closely follow each other (serially stacked apneas, ssOSA) exert greater effect on PWD compared to isolated OSA (iOSA) episodes. Methods: Sleeping patients (adults with mild-moderate OSA and presence of both iOSA and ssOSA, but without other cardiovascular comorbidities) undergoing diagnostic polysomnography were recorded by continuous 8-lead ECG. iOSA was defined as OSA episodes with no other episode within 30 seconds. ssOSA consisted of ≥3 consecutive apneas with inter-OSA intervals <30 seconds. PWD was defined from onset of p-wave in any ECG lead to termination in any lead (measured by digital calipers, averaged over 3 beats from first half of OSA and 3 beats from second half of OSA). Wilcoxon rank-sum test was used. Results: We analyzed 208 OSA episodes (51.0% iOSA, 49.0% ssOSA) which occurred in 12 patients (7 women; age 63.1±11.5 years; apnea hypopnea index 16.8±5.4). PWD was longer during ssOSA compared to iOSA (median 117.7ms vs 109.6ms; p<0.0001). The following variables did not differ between ssOSA and iOSA: PR interval (p=0.3139), RR interval (p=0.7531), peripheral oxygen saturation (p=0.7776). Conclusions: The impact of OSA on atrial conduction delay is exacerbated by the phenomenon of OSA stacking, which seems independent of oxygen desaturation and heart rate. Stacking of OSA episodes may be an underused and cost-efficient variable in evaluating the severity of OSA and the effectiveness of OSA treatments with the ultimate goal of reducing occurrence of AF.

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0692 Difference In Improvement Of ESS Score After CPAP Use In Patients From Different Workforces

SLEEP ◽

10.1093/sleep/zsaa056.688 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A264-A264

Author(s):

T R Mehta ◽

P Gurung ◽

L Digala ◽

Y Nene ◽

P C Bollu

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

White Collar ◽

Blue Collar ◽

University Of Missouri ◽

Initial Analysis ◽

Cardiovascular Comorbidities ◽

Institutional Review ◽

Obstructive Sleep ◽

The Difference

Abstract Introduction Obstructive sleep apnea (OSA) is characterized by recurrent occurrences of apnea and hypopnea throughout the night during sleep. Reported to prevail in 23.4% women and 49.7% men aged 40 years or older, OSA is considered to be the most preventable cause of excessive daytime sleepiness. Methods After obtaining approval from the institutional review board (IRB) for this retrospective study, a total of 825 patient records from a prospective registry of obstructive sleep apnea from our sleep lab affiliated with the University of Missouri Hospital were searched for variables including but not limited to age, race, gender, occupation, medications any sleep-related comorbidities, psychiatric comorbidities, cardiovascular comorbidities, pre CPAP ESS score and post CPAP ESS score. The mean improvement score of ESS in both these populations was compared and possible causes for the difference in these groups were analyzed. Results Initial analysis from 22 patients belonging to the white-collar and 22 patients belonging to the blue-collar workforce with a mean age of 49.27 (±14.28) years and a mean BMI of 37.60 (±9.41) showed a mean improvement of -1.27 and 0.63 respectively with no significance statistically. Statistical analysis will be performed after gathering data from a larger sample size. Conclusion Although insignificant, the blue-collar workforce showed more improvement than the white-collar workforce in the initial analysis. Support No support, financial or otherwise was used for this study.

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Obstructive Sleep Apnea and Cardiovascular Comorbidities

Medicine ◽

10.1097/md.0000000000000045 ◽

2014 ◽

Vol 93 (9) ◽

pp. e45 ◽

Cited By ~ 31

Author(s):

Hanna Gilat ◽

Shlomo Vinker ◽

Inon Buda ◽

Ethan Soudry ◽

Michal Shani ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Cardiovascular Comorbidities ◽

Obstructive Sleep

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Circulating microparticles and endothelial dysfunction in obstructive sleep apnea syndrome

Revue des Maladies Respiratoires ◽

10.1016/s0761-8425(08)75068-x ◽

2008 ◽

Vol 25 (9) ◽

pp. 1196

Author(s):

W. Trzepizur ◽

F. Gagnadoux ◽

P. Abraham ◽

M.L. Mastronardi ◽

A. Agouni ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Endothelial Dysfunction ◽

Obstructive Sleep Apnea Syndrome ◽

Sleep Apnea Syndrome ◽

Obstructive Sleep ◽

Circulating Microparticles ◽

Apnea Syndrome

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Circulating Microparticles from Patients with Obstructive Sleep Apnea Enhance Vascular Contraction

American Journal Of Pathology ◽

10.1016/j.ajpath.2012.06.020 ◽

2012 ◽

Vol 181 (4) ◽

pp. 1473-1482 ◽

Cited By ~ 10

Author(s):

Simon Tual-Chalot ◽

Keita Fatoumata ◽

Pascaline Priou ◽

Wojciech Trzepizur ◽

Abderahim Gaceb ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Vascular Contraction ◽

Obstructive Sleep ◽

Circulating Microparticles

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Obstructive Sleep Apnea Management in Patients with Cardiovascular Comorbidities

Hypertension News ◽

10.30824/2106-15 ◽

2021 ◽

Vol 65 ◽

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Cardiovascular Comorbidities ◽

Obstructive Sleep

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Ventricular Arrhythmias in Patients with Obstructive Sleep Apnea

Current Cardiology Reviews ◽

10.2174/1573403x14666181012153252 ◽

2018 ◽

Vol 15 (1) ◽

pp. 64-74 ◽

Cited By ~ 2

Author(s):

Rita Marinheiro ◽

Leonor Parreira ◽

Pedro Amador ◽

Dinis Mesquita ◽

José Farinha ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Ventricular Arrhythmias ◽

Positive Airway Pressure ◽

Etiologic Factor ◽

Mortality Benefit ◽

Cardiovascular Comorbidities ◽

Obstructive Sleep ◽

High Incidence ◽

Electrocardiographic Changes

Obstructive Sleep Apnea (OSA) is a prevalent condition thought to increase in the future. Being mostly undiagnosed, the most serious complications are cardiovascular diseases, among which are arrhythmias. Controversy remains as to whether OSA is a primary etiologic factor for ventricular arrhythmias, because of the high incidence of cardiovascular comorbidities in OSA patients. However, there is mostly a strong evidence of a relation between OSA and ventricular arrhythmias. A few mechanisms have been proposed to be responsible for this association and some electrocardiographic changes have also been demonstrated to be more frequent in OSA patients. Treatment of OSA with Continuous Positive Airway Pressure (CPAP) has the potential to reduce arrhythmias and confer a mortality benefit.

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