Obstructive Sleep Apnea Severity Is Associated with Left Ventricular Mass Independent of Other Cardiovascular Risk Factors in Morbid Obesity

Pujante, Pedro; Abreu, Cristina; Moreno, J.C.; Barrero, E.; Azcárate, P.; Campo, Arantza; Urrestarazu, Elena; Silva, Camilo; Maria, Jesus Gil; Tebar, J. Cifuentes; Frühbeck, Gema; Salvador, Javier

doi:10.5664/jcsm.3160

Cited by 21 publications

(12 citation statements)

References 33 publications

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“…The severity of OSA is typically determined by the number of hypopnea (partial obstruction) and apnea (complete obstruction) events per h of sleep, referred to as the apnea–hypopnea index (AHI) and categorized as mild (5 ≤ AHI < 15), moderate (15 ≤ AHI < 30), or severe (30 ≥ AHI). Numerous previous findings have shown that the risk or severity of chronic diseases and pathological conditions are dose-dependently associated with the OSA severity [ 3 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

Accelerated tumor growth under intermittent hypoxia is associated with hypoxia-inducible factor-1-dependent adaptive responses to hypoxia

Yoon

Min

et al. 2017

Oncotarget

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Mounting evidence has revealed a causative role of intermittent hypoxia (IH) in cancer progression in mouse models of obstructive sleep apnea (OSA), but most studies have focused on the effects of IH following tumor implantation using an exposure to single IH frequency. Thus, we aimed to investigate 1) the potential effect of IH on the initial tumor growth in patients with OSA without an interaction with other mechanisms induced by IH in mice and 2) the influence of the IH frequency on tumor growth, which were tested using pre-conditioning with IH (Pre-IH) and 2 different IH frequencies, respectively. Pre-IH was achieved by alternatively maintaining melanoma cells between normoxia (10 min, 21% O2) and hypoxia (50 min, 1% O2) for 7 days (12 cycles per day) before administering them to mice. The conditions for IH-1 and IH-2 were 90 s of 12% FiO2 followed by 270s of 21% FiO2 (10 cycles/h), and 90 s of 12% FiO2 and 90 s of 21% FiO2 (20 cycles/h), respectively, for 8 h per day. Tumor growth was significantly higher in the Pre-IH group than in the normoxia group. In addition, the IH-2 group showed more accelerated tumor growth compared to the normoxia and IH-1 groups. Immunohistochemistry and gene-expression results consistently showed the up-regulation of molecules associated with HIF-1α-dependent hypoxic adaptation in tumors of the Pre-IH and IH-2 groups. Our findings reveal that IH increased tumor progression in a frequency-dependent manner, regardless of whether it was introduced before or after in vivo tumor cell implantation.

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Section: Introductionmentioning

confidence: 99%

Accelerated tumor growth under intermittent hypoxia is associated with hypoxia-inducible factor-1-dependent adaptive responses to hypoxia

Yoon

Min

et al. 2017

Oncotarget

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“…62,63 Anthropometric parameters, such as neck circumference and waist circumference, are associated with severity of OSAS. 64,65 Moreover, abdominal obesity is considered an independent risk factor for predicting sleep duration and sleep disorders. 66,67 Based on waist circumference, the specificity provided by the ROC curve was greater than 85% and therefore has a great value as a screening method for women without accurately diagnosed OSAS.…”

Section: Discussionmentioning

confidence: 99%

Waist circumference and postmenopause stages as the main associated factors for sleep apnea in women

et al. 2015

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OSAS is prevalent in postmenopausal women, especially in late postmenopause. This study highlights the association between waist circumference, early postmenopause and late postmenopause, and severity of OSAS. Our findings suggest that postmenopause stages may potentially exacerbate the presence of sleep disturbance and that reducing waist circumference may be an important strategy for managing OSAS in women.

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“…OSA is a well-established independent risk factor for LVH in adults, both through hemodynamic and nonhemodynamic mechanisms [52]. Cloward et al demonstrated that treatment of OSA in adults resulted in a reduction in interventricular septal thickness [53].…”

Section: Discussionmentioning

confidence: 99%

Left Ventricular Geometrical Changes in Severely Obese Adolescents: Prevalence, Determinants, and Clinical Implications

et al. 2020

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Left ventricular hypertrophy (LVH) is independently associated with a higher risk of cardiovascular morbidity and mortality in adults. Adiposity is a risk factor for LVH, independent of blood pressure. Potential causes of this nonhemodynamic pathogenesis identified in adults include adverse body fat distribution, insulin resistance, dyslipidemia, and obstructive sleep apnea syndrome (OSA). In severely obese adolescents, the determinants of obesity-induced changes in left ventricular structure are poorly characterized. Cardiac ultrasonographic, demographic, anthropometric, and comorbidity-related data were prospectively collected in adolescents with severe obesity refractory to conservative treatment who presented for surgical therapy. Differences between adolescents with LVH and without LVH were evaluated using independent samples t, chi-square, or Fisher’s exact test. Multivariable linear regression analysis was performed to evaluate associations with left ventricular structural changes, corrected for body mass index (BMI) z score. Forty-three patients entered analysis, of whom 24 (55.8%) showed LVH. The most common geometrical change was eccentric LVH (eLVH), occurring in 21 subjects (48.8%). Demographic and anthropometric variables did not differ between patients with and without LVH. Independent of BMI z score, left ventricular mass index was significantly associated with apnea–hypopnea index (AHI) (regression parameter B = 0.8; 95% CI 0.3 to 1.2). Interventricular septum thickness (IVST) was significantly associated with HOMA-IR values (B = 0.1; 95% CI 0.04 to 0.2), HDL-cholesterol (B = − 1.2; 95% CI − 2.2 to 0.1), and triglyceride levels (B = 0.5; 95% CI 0.001 to 0.9). LVH, especially eLVH, is highly prevalent amongst severely obese adolescents. Adverse changes in cardiac structure, increased IVST in particular, are independently associated with several nonhemodynamic comorbidities that are common in this population, namely OSA, insulin resistance, and dyslipidemia.

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Obstructive Sleep Apnea Severity Is Associated with Left Ventricular Mass Independent of Other Cardiovascular Risk Factors in Morbid Obesity

Cited by 21 publications

References 33 publications

Accelerated tumor growth under intermittent hypoxia is associated with hypoxia-inducible factor-1-dependent adaptive responses to hypoxia

Accelerated tumor growth under intermittent hypoxia is associated with hypoxia-inducible factor-1-dependent adaptive responses to hypoxia

Waist circumference and postmenopause stages as the main associated factors for sleep apnea in women

Left Ventricular Geometrical Changes in Severely Obese Adolescents: Prevalence, Determinants, and Clinical Implications

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