Feng Lanxin, Zhao Xin, Song Jianqiao, Yang Shuwen, Xiang Jianping, Zhang Min, Tu Chenchen, Song Xiantao
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, People's Republic of China.
Sun Yat Sen University, Zhongshan School of Medicine, Guangzhou, People's Republic of China.
Nat Sci Sleep. 2024 Dec 28;16:2279-2288. doi: 10.2147/NSS.S494018. eCollection 2024.
There is a connection between obstructive sleep apnea (OSA) and coronary microvascular dysfunction (CMD), but the underlying mechanisms remain unclear. This study aims to evaluate the correlation between OSA-related nocturnal hypoxemia parameters and CMD.
This is an observational, single-center study that included patients who underwent polysomnography and coronary angiography during hospitalization. The presence of CMD was determined by angio-based index of microcirculatory resistance (AccuIMR). Categorical variables were compared using chi-square test or Fisher exact test. The -test and Mann-Whitney -test were used to compare normally and non-normally distributed continuous variables, respectively. Univariate and multivariable logistic regression analyses were performed to evaluate the relationship between nocturnal hypoxemia parameters and CMD.
A total of 133 patients were included in this study, of whom 72 (54.14%) had evidence of CMD. Patients with CMD exhibited a higher prevalence of OSA and experienced more severe nocturnal hypoxia. After adjusting for potential confounding factors, minimum oxygen saturation (minSpO) ≤90% (OR 5.89; 95% CI 1.73-19.99; =0.004) and the percentage of time spent with oxygen saturation below 90% (T90) ≥5% (OR 3.13; 95% CI 1.05-9.38; =0.041) were independently associated with CMD. However, no significant association was observed between apnea-hypopnea index (AHI) and CMD.
Parameters of nocturnal hypoxemia are associated with CMD. Hypoxemia parameters may more sensitively reflect the correlation between OSA and CMD than AHI.
阻塞性睡眠呼吸暂停（OSA）与冠状动脉微血管功能障碍（CMD）之间存在联系，但其潜在机制仍不清楚。本研究旨在评估与OSA相关的夜间低氧血症参数与CMD之间的相关性。
这是一项观察性单中心研究，纳入了住院期间接受多导睡眠图检查和冠状动脉造影的患者。CMD的存在通过基于血管造影的微循环阻力指数（AccuIMR）来确定。分类变量采用卡方检验或Fisher精确检验进行比较。分别使用t检验和Mann-Whitney U检验来比较正态分布和非正态分布的连续变量。进行单变量和多变量逻辑回归分析以评估夜间低氧血症参数与CMD之间的关系。
本研究共纳入133例患者，其中72例（54.14%）有CMD证据。CMD患者的OSA患病率更高，夜间低氧更严重。在调整潜在混杂因素后，最低氧饱和度（minSpO）≤90%（比值比5.89；95%置信区间1.73 - 19.99；P = 0.004）和氧饱和度低于90%的时间百分比（T90）≥5%（比值比3.13；95%置信区间1.05 - 9.38；P = 0.041）与CMD独立相关。然而，未观察到呼吸暂停低通气指数（AHI）与CMD之间存在显著关联。
夜间低氧血症参数与CMD相关。低氧血症参数可能比AHI更敏感地反映OSA与CMD之间的相关性。
