Blekic Nathan, Bold Ionela, Mettay Thomas, Bruyneel Marie
Department of Pulmonary Medicine, Saint-Pierre University Hospital, Brussels, Belgium and Université Libre de Bruxelles, Brussels, Belgium.
Department of Pulmonary Medicine, Brugmann University Hospital, Brussels, Belgium and Université Libre de Bruxelles, Brussels, Belgium.
Nat Sci Sleep. 2022 Aug 25;14:1457-1468. doi: 10.2147/NSS.S374572. eCollection 2022.
Various phenotypes of obstructive sleep apnea (OSA) have been recently described and are poorly assessed by the commonly used polysomnographic indices, such as the apnea-hypopnea index and oxygen desaturation index. Nocturnal hypoxemia is the hallmark of OSA and new quantitative markers, as hypoxic burden or desaturation severity, have been shown to be associated with cardiovascular (CV) mortality. The purpose of this overview is to review the endophenotypical and clinical characteristics of OSA, the current metrics, and to analyze different measurements of hypoxemia in OSA to predict the cardiovascular impact (eg hypoxic burden). Potential interest of multidimensional models to classify OSA, such as BAVENO classification, is also discussed, with the goal of focusing on specific endophenotypes that are likely to develop CV comorbidities, in order to guide clinicians to more aggressive management of OSA in these individuals.
阻塞性睡眠呼吸暂停（OSA）的各种表型最近已有描述，而常用的多导睡眠图指标，如呼吸暂停低通气指数和氧饱和度下降指数，对其评估效果不佳。夜间低氧血症是OSA的标志，新的定量指标，如低氧负荷或饱和度下降严重程度，已被证明与心血管（CV）死亡率相关。本综述的目的是回顾OSA的内表型和临床特征、当前的测量指标，并分析OSA中低氧血症的不同测量方法，以预测心血管影响（如低氧负荷）。还讨论了多维模型（如BAVENO分类）对OSA进行分类的潜在意义，目的是关注可能发展为心血管合并症的特定内表型，以便指导临床医生对这些个体进行更积极的OSA管理。
