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
{"title":"Heart Rate response and cardiovascular risk during OSA: an easy biomarker derived from pulse oximetry.","authors":"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","doi":"10.1183/13993003.01883-2024","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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<sub>oxi</sub>) with CV risk in OSA.</p><p><strong>Methods: </strong>ΔHR<sub>oxi</sub> and ΔHR were measured in OSA patients from the <i>IRSR Pays de la Loire Sleep Cohort</i> (<i>PLSC;</i> n=5,002) and the <i>HypnoLaus</i> cohort (n=1,307). The primary outcome was major adverse CV events (MACEs), a composite of mortality, stroke, and cardiac diseases. Cox regressions analyses were conducted to evaluate the association of ΔHR<sub>oxi</sub> and ΔHR categorized into low, midrange and high categories, with MACEs.</p><p><strong>Results: </strong>MACEs occured in 768 patients from <i>PLSC</i> and 87 patients from <i>HypnoLaus</i> (median follow-up: 8.0 and 7.5 years respectively). Multivariable Cox models showed that subjects with high ΔHR<sub>oxi</sub> (vs midrange) had higher risk of MACEs in <i>PLSC</i> (hazard ratio, HR: 1.42 [95% CI:1.18-1.71]) and <i>HypnoLaus</i> (HR: 1.72 [1.03-2.87]). Similar findings were observed for high ΔHR. Among 2,718 patients from <i>PLSC</i> treated with PAP, the association of PAP adherence (PAP use ≥4 h/night, vs non adherence) with MACEs was modified by baseline ΔHR and ΔHR<sub>oxi</sub> (p for interaction<0.05).</p><p><strong>Conclusions: </strong>ΔHR<sub>oxi</sub> could constitute a reliable and easy to measure biomarker for stratifying CV risk and predicting CV benefit of PAP in OSA.</p>","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":16.6000,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Respiratory Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1183/13993003.01883-2024","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
Heart Rate response and cardiovascular risk during OSA: an easy biomarker derived from pulse oximetry.
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 (ΔHRoxi) with CV risk in OSA.
Methods: ΔHRoxi and ΔHR were measured in OSA patients from the IRSR Pays de la Loire Sleep Cohort (PLSC; n=5,002) and the HypnoLaus cohort (n=1,307). The primary outcome was major adverse CV events (MACEs), a composite of mortality, stroke, and cardiac diseases. Cox regressions analyses were conducted to evaluate the association of ΔHRoxi and ΔHR categorized into low, midrange and high categories, with MACEs.
Results: MACEs occured 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 ΔHRoxi (vs midrange) had higher risk of MACEs in PLSC (hazard ratio, HR: 1.42 [95% CI:1.18-1.71]) and HypnoLaus (HR: 1.72 [1.03-2.87]). Similar findings were observed for high ΔHR. Among 2,718 patients from PLSC treated with PAP, the association of PAP adherence (PAP use ≥4 h/night, vs non adherence) with MACEs was modified by baseline ΔHR and ΔHRoxi (p for interaction<0.05).
Conclusions: ΔHRoxi could constitute a reliable and easy to measure biomarker for stratifying CV risk and predicting CV benefit of PAP in OSA.
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.
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