系统性高血压合并阻塞性睡眠呼吸暂停患者左室舒张末期容积与心血管疾病的关系

IF 3.4 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine Pub Date : 2026-05-01 Epub Date: 2026-02-09 DOI:10.1016/j.sleep.2026.108832

Sharezhati Yishajiang , Qing Zhu , Delian Zhang , Shasha Liu , Mengru Wang , Ting Wu , Jing Hong , Nanfang Li

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引用次数: 0

摘要

背景与目的：全身性高血压和阻塞性睡眠呼吸暂停（OSA）是密切相关的疾病，可显著增加心血管疾病（CVD）的风险。左室舒张末期容积（LVEDV）是心脏重构的重要超声心动图指标；然而，其在伴有全身性高血压和OSA患者中的预后价值仍不明确。本研究旨在研究高危人群中LVEDV与CVD发病率之间的关系。方法本回顾性队列研究纳入确诊的全身性高血压和OSA患者，根据基线LVEDV分层。采用多变量Cox比例风险模型，对人口统计学因素、合并症和OSA严重程度进行调整，评估CVD风险。进行敏感性和分层分析以评估研究结果的稳健性。结果共对1914例患者（平均年龄48.7±10.2岁）进行了83个月的随访，其中记录了186例CVD事件。CVD的发病率在LVEDV的各个阶段逐渐增加。在完全校正分析中，最高分位数（T3: >81 mL）的患者患心血管疾病的风险明显高于最低分位数（T1: <70 mL）的患者（风险比[HR] = 1.86； 95%可信区间[CI]: 1.30-2.67; P = 0.001）。虽然在T2: 70-81 mL中，观察到较高的风险，但这种关联没有达到统计学意义（HR = 1.29; 95% CI: 0.88-1.88; P = 0.19）。这些关联在敏感性和分层分析中保持稳定。结论LVEDV升高与同时存在全身性高血压和OSA患者CVD风险增加独立相关。这些发现支持LVEDV作为一种新颖且易于获得的超声心动图生物标志物，用于该人群的心血管风险分层。LVEDV的常规评估可能有助于早期识别高风险个体，并为osa相关全身性高血压患者提供及时的预防策略。

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Association between left ventricular end-diastolic volume and cardiovascular disease in systemic hypertensive patients with obstructive sleep apnea

Background and purpose

Systemic hypertension and obstructive sleep apnea (OSA) are closely linked conditions that substantially increase the risk of cardiovascular disease (CVD). Left ventricular end-diastolic volume (LVEDV) is a crucial echocardiographic marker of cardiac remodeling; however, its prognostic value in patients with concomitant systemic hypertension and OSA remains poorly defined. This study aimed to examine the association between LVEDV and the incidence of CVD in this high-risk population.

Methods

This retrospective cohort study included patients with confirmed systemic hypertension and OSA, who were stratified into tertiles based on baseline LVEDV. Multivariable Cox proportional hazards models, adjusted for demographic factors, comorbid conditions, and OSA severity, were used to evaluate CVD risk. Sensitivity and stratified analyses were conducted to assess the robustness of the findings.

Results

A total of 1914 patients (mean age 48.7 ± 10.2 years) were followed for a median of 83 months, during which 186 incident CVD events were documented. The incidence of CVD increased progressively across LVEDV tertiles. In fully adjusted analyses, patients in the highest tertile (T3: >81 mL) showed a significantly higher risk of CVD compared with those in the lowest tertile (T1: <70 mL) (hazard ratio [HR] = 1.86; 95% confidence interval [CI]: 1.30–2.67; P = 0.001). Although a higher risk was observed for the intermediate tertile (T2: 70–81 mL), this association did not reach statistical significance (HR = 1.29; 95% CI: 0.88–1.88; P = 0.19). These associations remained stable across sensitivity and stratified analyses.

Conclusion

Elevated LVEDV is independently associated with an increased risk of CVD in patients with coexisting systemic hypertension and OSA. These findings support LVEDV as a novel and readily obtainable echocardiographic biomarker for cardiovascular risk stratification in this population. Routine assessment of LVEDV may enable earlier identification of individuals at heightened risk and inform timely preventive strategies in patients with OSA-related systemic hypertension.

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来源期刊

Sleep medicine 医学-临床神经学

CiteScore

8.40

自引率

6.20%

发文量

1060

审稿时长

49 days

期刊介绍： Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without. A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry. The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.