Heart rate response and cardiovascular risk during obstructive sleep apnoea: an easy biomarker derived from pulse oximetry.

IF 16.6 1区医学 Q1 RESPIRATORY SYSTEM

European Respiratory Journal Pub Date : 2025-05-06 Print Date: 2025-05-01 DOI:10.1183/13993003.01883-2024

Margaux Blanchard, Théo Imler, Wen-Hsin Hu, Adrien Waeber, Geoffroy Solelhac, José Haba-Rubio, Sandrine Kerbrat, Abdelkebir Sabil, Wojciech Trzepizur, François Goupil, Audrey Thomas, Sébastien Bailly, Ali Azarbarzin, Peter Vollenweider, Pedro Marques-Vidal, Julien Vaucher, Raphael Heinzer, Frédéric Gagnadoux

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引用次数: 0

Abstract

Background: Sleep apnoea-specific heart rate response (ΔHR) has been identified as a promising biomarker for stratifying cardiovascular (CV) risk and predicting positive airway pressure (PAP) benefit in obstructive sleep apnoea (OSA). However, the need for prior manual scoring of respiratory events potentially limits the accessibility and reproducibility of ΔHR. We aimed to evaluate the association of pulse rate response to oxygen desaturations automatically derived from pulse oximetry (ΔHR_oxi) with CV risk in OSA.

Methods: ΔHR_oxi and ΔHR were measured in OSA patients from the Institut de Recherche en Santé Respiratoire Pays de la Loire Sleep Cohort (PLSC; n=5002) and the HypnoLaus cohort (n=1307). The primary outcome was major adverse CV events (MACEs), a composite of mortality, stroke and cardiac diseases. Cox regression analyses were conducted to evaluate the association of ΔHR_oxi and ΔHR, categorised into low, midrange and high categories, with MACEs.

Results: MACEs occurred in 768 patients from PLSC and 87 patients from HypnoLaus (median follow-up 8.0 and 7.5 years, respectively). Multivariable Cox models showed that subjects with high ΔHR_oxi (versus midrange) had higher risk of MACEs in PLSC (hazard ratio (HR) 1.42, 95% CI 1.18-1.71) and HypnoLaus (HR 1.72, 95% CI 1.03-2.87). Similar findings were observed for high ΔHR. Among 2718 patients from PLSC treated with PAP, the association of PAP adherence (PAP use ≥4 h·night^-1 versus non-adherent) with MACEs was modified by baseline ΔHR and ΔHR_oxi (p_interaction<0.05).

Conclusion: ΔHR_oxi could constitute a reliable and easy to measure biomarker for stratifying CV risk and predicting CV benefit of PAP in OSA.

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呼吸暂停期间的心率反应和心血管风险：从脉搏血氧测定中获得的简单生物标志物。

背景：睡眠呼吸暂停特异性心率反应（ΔHR）已被确定为一种很有前景的生物标志物，可用于对阻塞性睡眠呼吸暂停（OSA）患者进行心血管（CV）风险分层并预测气道正压（PAP）的益处。然而，由于需要事先对呼吸事件进行人工评分，ΔHR 的可及性和可重复性受到了潜在的限制。我们的目的是评估脉搏血氧仪（ΔHRoxi）自动得出的氧不饱和脉率反应与 OSA 中 CV 风险的关系。方法：对 IRSR 卢瓦尔河地区睡眠队列（PLSC；n=5002）和 HypnoLaus 队列（n=1307）中的 OSA 患者进行ΔHRoxi 和 ΔHR 测量。主要研究结果是主要心血管不良事件（MACEs），即死亡率、中风和心脏病的综合指数。对ΔHRoxi和分为低、中、高三类的ΔHR与MACEs的关系进行了Cox回归分析：768名PLSC患者和87名HypnoLaus患者发生了MACE（中位随访时间分别为8.0年和7.5年）。多变量 Cox 模型显示，在 PLSC（危险比 HR：1.42 [95% CI：1.18-1.71]）和 HypnoLaus（HR：1.72 [1.03-2.87]）中，ΔHRoxi 较高（与中值相比）的受试者发生 MACE 的风险较高。高ΔHR也有类似结果。在接受PAP治疗的2718名PLSC患者中，PAP依从性（PAP使用时间≥4小时/晚，与非依从性相比）与MACEs的关系受基线ΔHR和ΔHRoxi的影响（p为交互作用结论：ΔHRoxi可作为一种可靠且易于测量的生物标志物，用于对OSA患者的CV风险进行分层并预测PAP对CV的益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Respiratory Journal 医学-呼吸系统

CiteScore

27.50

自引率

3.30%

发文量

345

审稿时长

2-4 weeks

期刊介绍： The European Respiratory Journal (ERJ) is the flagship journal of the European Respiratory Society. It has a current impact factor of 24.9. The journal covers various aspects of adult and paediatric respiratory medicine, including cell biology, epidemiology, immunology, oncology, pathophysiology, imaging, occupational medicine, intensive care, sleep medicine, and thoracic surgery. In addition to original research material, the ERJ publishes editorial commentaries, reviews, short research letters, and correspondence to the editor. The articles are published continuously and collected into 12 monthly issues in two volumes per year.