Cardiovascular diseases across OSA phenotypes: A retrospective cohort study

Khaled Al Oweidat; Ahmad A Toubasi; Thuraya N Al-Sayegh; Rima A Sinan; Sara H Mansour; Hanna K Makhamreh

doi:10.1016/j.sleepx.2023.100090

Cardiovascular diseases across OSA phenotypes: A retrospective cohort study

Sleep Med X. 2023 Oct 14:6:100090. doi: 10.1016/j.sleepx.2023.100090. eCollection 2023 Dec 15.

Authors

Khaled Al Oweidat¹, Ahmad A Toubasi², Thuraya N Al-Sayegh², Rima A Sinan², Sara H Mansour², Hanna K Makhamreh³

Affiliations

¹ Department of Respiratory and Sleep Medicine, Department of Internal Medicine, School of Medicine, The University of Jordan, Amman, Jordan.
² Faculty of Medicine, The University of Jordan, Amman, Jordan.
³ Department of Cardiology, Department of Internal Medicine, School of Medicine, The University of Jordan, Amman, Jordan.

Abstract

Background: Despite the considerable knowledge of Obstructive Sleep Apnea (OSA) implications for cardiac diseases, the evidence regarding cardiovascular complications across OSA phenotypes including Rapid Eye Movement OSA (REM-OSA) and Positional OSA (POSA) is limited. In this study, we aimed to evaluate the risk of cardiovascular diseases development and progression among patients with REM-OSA and POSA.

Methods: Based on a retrospective cohort analysis, we included polysomnography studies done in the sleep lab at the Jordan University Hospital. Regarding cardiovascular diseases, primary outcomes were Heart Failure, and 1-years Major Adverse Cardiac Events while secondary outcomes were atrial fibrillation, pulmonary hypertension, other arrhythmia, metabolic profile, and echocardiographic measurements of the heart.

Results: The total number of the included patients was 1,026 patients. POSA group had significantly lower percentage of patients with hypertension (P-value = 0.004). Additionally, systolic blood pressure and HbA1c were significantly lower among patients with POSA compared to the NPOSA group (P-value<0.050). Left ventricular end diastolic dimension was significantly higher among patients with POSA while ejection fraction was significantly lower (P-value<0.050). Patients with diabetes and mean HbA1c were significantly lower among patients with REM-OSA compared to patients with NREM-OSA (P-value = 0.015, P-value = 0.046). Multivariate regression analysis revealed that after adjusting for age, gender and preexisting comorbidities, POSA was significantly associated with lower ejection fraction and higher left ventricular diastolic diameter.

Conclusion: In conclusion, our findings indicate that POSA might be associated with huge and clinically significant heart strain and poor cardiac functions, yet it might not have a clinically significant atherogenic effect. This study should guide clinicians to identify OSA phenotypes to imply the best treatment plan to reduce its detrimental impact on cardiac muscle.

Keywords: Cardiovascular diseases; Heart failure; Human; OSA; Sleep.