Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
Clin Cardiol. 2020 Jul;43(7):803-811. doi: 10.1002/clc.23385. Epub 2020 May 27.
Obstructive sleep apnea (OSA) is highly prevalent in patients with hypertrophic obstructive cardiomyopathy (HOCM). Inflammatory responses are increased in patients with OSA, meanwhile, inflammation is also associated with adverse outcomes in HOCM.
To investigate the association between severity of OSA and high-sensitivity C-reactive protein (hs-CRP) in patients with HOCM.
Three hundred and ninteen patients with HOCM who underwent sleep evaluations at Fuwai Hospital were retrospectively included between February 2010 and December 2018. Data from baseline clinical characteristics and polysomnography studies were collected.
OSA was present in 168 (52.7%). Patients with OSA were older, more likely to be male, had a higher body mass index and more clinical comorbidities. Patients with OSA had enlarged left ventricular diameter and similar left ventricular outflow tract obstruction compared with those without. In multivariate logistic analysis, apnea-hypopnea index (OR, 1.024; 95% CI, 1.005-1.044; P = .014), oxygen desaturation index (OR, 1.025; 95% CI, 1.004-1.046; P = .018) and lowest oxygen saturation (OR, 0.951; 95% CI, 0.915-0.989; P = .011) were independently associated with high risk hs-CRP (>3 mg/L) after adjusting for confounders. In addition, decreasing lowest oxygen saturation (β = -.159, P = .004) was also independently correlated with increasing hs-CRP concentrations in multivariate linear analysis after adjusting for confounders.
Severity of OSA was independently associated with elevated hs-CRP levels in patients with HOCM. Further studies are needed to evaluate the effects of treating OSA on hs-CRP as well as clinical outcomes in these patients.
阻塞性睡眠呼吸暂停（OSA）在肥厚型梗阻性心肌病（HOCM）患者中非常普遍。OSA 患者的炎症反应增加，而炎症也与 HOCM 的不良结局有关。
研究 HOCM 患者中 OSA 严重程度与高敏 C 反应蛋白（hs-CRP）之间的关系。
回顾性纳入 2010 年 2 月至 2018 年 12 月期间在阜外医院接受睡眠评估的 319 例 HOCM 患者。收集基线临床特征和多导睡眠图研究的数据。
168 例（52.7%）患者存在 OSA。OSA 患者年龄较大，更可能为男性，体重指数较高，且合并症更多。与无 OSA 患者相比，OSA 患者的左心室直径增大，左心室流出道梗阻相似。在多变量 logistic 分析中，呼吸暂停-低通气指数（OR，1.024；95%CI，1.005-1.044；P =.014）、氧减指数（OR，1.025；95%CI，1.004-1.046；P =.018）和最低血氧饱和度（OR，0.951；95%CI，0.915-0.989；P =.011）与调整混杂因素后高风险 hs-CRP（>3mg/L）独立相关。此外，在调整混杂因素后，多元线性分析中最低血氧饱和度的降低（β=-.159，P =.004）与 hs-CRP 浓度的增加也呈独立相关。
OSA 的严重程度与 HOCM 患者 hs-CRP 水平升高独立相关。需要进一步研究评估治疗 OSA 对这些患者 hs-CRP 以及临床结局的影响。
