Sleep Apnea and Sudden Cardiac Death

Ryu

J. Racial and Ethnic Health Disparities

et al. 2023

Objective This study examines associations between the risk of sleep apnea and abdominal obesity (assessed by waist-to-hip ratio (WHR)) and general obesity (assessed by body mass index (BMI)) in a sample of Chinese and Korean American immigrants. Methods The dataset included Chinese and Korean participants aged 50–75 who were recruited from primary care physicians’ clinics from April 2018 to June 2020 in the Baltimore-Washington D.C. Metropolitan area ( n = 394). Abdominal obesity was determined if WHR ≥ 0.9 in men and WHR ≥ 0.85 in women. General obesity was determined if BMI ≥ 30. The risk of sleep apnea was determined by using the Berlin questionnaire. Poisson regression models examined associations between sleep apnea risk and obesity. Models controlled for socio-demographic risk factors. Results Twelve percent of the study participants were classified as a high risk for sleep apnea, and 75% had abdominal obesity whereas 6.4% had general obesity. High risk of sleep apnea was positively associated with abdominal obesity ( PR = 1.31, 95% CI: 1.17–1.47) and general obesity ( PR = 2.19, 95% CI: 0.90–5.32), marginally significant at p < 0.1). Conclusions Chinese and Korean immigrants living in the USA who are at high risk of sleep apnea have higher abdominal obesity, even after accounting for sociodemographic characteristics. Abdominal obesity may be a better indicator than general obesity when examining the risk of sleep apnea among Asian Americans. Information on Clinical Trial Name: Screening To Prevent ColoRectal Cancer (STOP CRC) among At-Risk Asian American Primary Care Patients NCT Number: NCT03481296; Date of registration: March 29, 2018 URL: https://clinicaltrials.gov/ct2/show/NCT03481296?term=Sunmin+Lee&draw=2&rank=1

Section: Introductionmentioning

confidence: 99%

Risk of Sleep Apnea Is Associated with Abdominal Obesity Among Asian Americans: Comparing Waist-to-Hip Ratio and Body Mass Index

Ryu

J. Racial and Ethnic Health Disparities

et al. 2023

“…It is shown that OSA is an independent risk factor for hypertension, coronary artery disease, type 2 diabetes mellitus, and diabetic kidney disease ( Tahrani, 2017 ; Strausz et al, 2018 ). Patients with OSA are more susceptible to heart failure, arrhythmias, myocardial infarction, stroke, and sudden death ( Roca et al, 2015 ; Blackwell et al, 2019 ). Regarding our study population, we observed a significantly higher number of participants with obesity, prior hypertension, coronary artery disease, and diabetes mellitus when compared to the general population ( Saeedi et al, 2019 ; Khan et al, 2020 ; Mills et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Obstructive Sleep Apnea and Cardiovascular Risk: The Role of Dyslipidemia, Inflammation, and Obesity

et al. 2022

Introduction: The present study aimed to establish the role of lipid abnormalities and inflammatory markers for developing cardiovascular risk, as well as to address the importance of obesity as a common comorbidity in patients with obstructive sleep apnea (OSA).Methods: The study was conducted as a prospective cohort study including 120 patients with newly diagnosed OSA between 2019 and 2020, at University Clinical Hospital Center “Bezanijska kosa”, Belgrade, Serbia. The diagnosis was established by polysomnography. In all patients, sociodemographic data, respiratory, lipid, and inflammatory parameters were collected and complete echocardiographic study and 24-h blood pressure monitoring were performed.Results: The mean patient age was 55.7 ± 13.8 years. Study population was mostly male (70.0%) and obese (56.7%). At least 30 apneas or hypopneas per hour were present in 39.0% of patients. A strong positive correlation was found between OSA severity and BMI (r = 0.562, p < 0.001), both associated with lipid, inflammatory and respiratory parameters, and cardiovascular profile of patients with OSA (p < 0.05 for all). Echocardiographic study and 24-h blood pressure monitoring parameters were in turn correlated with lipid and inflammatory markers (p < 0.05 for all).Conclusion: The results of this study support the important role of dyslipidemia and inflammation, as well as coexistence of obesity in the pathogenesis of numerous conditions linked with an increased risk of cardiovascular morbidity and mortality in patients with OSA.

“…11 A growing body of empirical evidence also indicates that SDB is a risk factor for sudden cardiac death. [12][13][14][15] The role of SDB in triggering malignant arrhythmias can be assessed through its association with abnormal electrocardiographic (ECG) features known to indicate the risk of sudden cardiac death. It is well established that the beat-to-beat QT variability index (QTVI), a measure of ventricular repolarization lability, is predictive of ventricular arrhythmias and sudden cardiac death.…”

Section: Introductionmentioning

confidence: 99%

“…11 A growing body of empirical evidence also indicates that SDB is a risk factor for sudden cardiac death. 12-15…”

Section: Introductionmentioning

confidence: 99%

Sleep-Disordered Breathing Destabilizes Ventricular Repolarization

Solhjoo

Haigney

Siddharthan³

et al. 2023

Preprint

BACKGROUND: Sleep-disordered breathing (SDB) is associated with an increased risk of cardiac arrhythmias, sudden cardiac death, and all-cause mortality. This study investigates the mechanisms underlying this association by examining the effects of prevalent and incident SDB and intermittent hypoxia on ventricular repolarization lability. METHODS: Electrocardiographic recordings from three cohorts were used for this study: (1) a cross-sectional sample of 61 participants with severe SDB and a matched group without SDB; (2) a longitudinal sample of 26 participants without SDB at baseline who developed SDB after a 5 year follow-up, and a matched group without SDB; and (3) a cohort of 19 healthy adults exposed to intermittent hypoxia or ambient air. Mean heart rate, heart rate variability (SDNN), and QT variability index (QTVI), a measure of ventricular repolarization lability, were calculated from one-lead ECG recordings. RESULTS: In the cross-sectional sample, participants with severe SDB had larger QTVI (P = 0.027), heart rate (P = 0.028), SDNN (P = 0.018), and hypoxemia burden as assessed by the total sleep time with oxygen saturation less than 90% (TST90; P < 0.001) than those without SDB. TST90, but not the frequency of arousals, was an independent predictor of QTVI (P = 0.017). Both heart rate and QTVI were predictive of all-cause mortality. In the longitudinal sample with incident SDB, QTVI increased from -1.23 ± 0.15 to 0.86 {plus minus} 0.14 (P = 0.017) over the 5-year follow-up period. Finally, in the cohort of healthy adults, 4 hours of exposure to intermittent hypoxia increased heart rate (P = 0.001) and QTVI (P = 0.016). CONCLUSIONS: Prevalent and incident SDB are associated with increased ventricular repolarization instability which predisposes to ventricular arrhythmias and sudden cardiac death. Intermittent hypoxemia can destabilize ventricular repolarization and is a likely mediator of increased mortality in SDB.