Heart failure with preserved ejection fraction risk is associated with prevalence and severity of obstructive sleep apnea.

STUDY OBJECTIVES

While heart failure with preserved ejection fraction (HFpEF) is associated with the presence of obstructive sleep apnea (OSA), few studies have examined the association between scoring systems used to predict HFpEF risk, such as the HFPEF and HFA-PEFF scores, and OSA prevalence and severity.

METHODS

We performed chart review on all patients who underwent both an echocardiogram and sleep study at the University of Pennsylvania between July 1, 2020, and June 30, 2022. There were 277 patients in the final cohort after excluding patients with relevant comorbidities. Associations between echocardiographic parameters and OSA severity, as well as between HFPEF score and OSA severity, were examined using linear tests of trend. The association between HFPEF score and prevalent OSA was examined with logistic regression.

RESULTS

OSA severity was associated with echocardiographic markers, including left atrial volume index ( = .03) and left ventricular relative thickness ( = .008). Patients with high HFPEF risk scores had over 17-fold higher odds of prevalent OSA compared with those with low-risk scores (17.7; 95% CI 4.3, 120.7; < .001). Higher HFPEF scores were strongly correlated with OSA severity ( < .001). After controlling for body mass index, HFPEF scores were not associated with prevalence or severity of OSA.

CONCLUSIONS

In an ambulatory population referred for sleep study and echocardiogram, markers of diastolic dysfunction were associated with OSA severity. OSA prevalence and severity were associated with increased HFPEF scores, although these associations were largely explained by obesity. Clinicians should have low thresholds for referring patients with OSA for cardiac workup and patients with HFpEF for sleep study.

CITATION

Connolly JE, Genuardi MV, Mora JI, Prenner SB. Heart failure with preserved ejection fraction risk is associated with prevalence and severity of obstructive sleep apnea. . 2024;20(3):381-387.