Sivam S, Wang D, Wong K, Piper A, Zheng Z, Gauthier G, Hockings C, Guinness O, Menadue C, Melehan K, Cooper S, Hilmisson H, Phillips C, Thomas R, Yee B, Grunstein R. Cardiopulmonary coupling and serum cardiac biomarkers in obesity hypoventilation syndrome and obstructive sleep apnea with morbid obesity. Journal of Clinical Sleep Medicine [Epub., ahead of print] DOI: 10.5664/jcsm.9804
The main cause of death in patients with obesity hypoventilation syndrome (OHS) is cardiac rather than respiratory failure. In this study the focus is on autonomic-respiratory coupling (CPC) and serum cardiac biomarkers in patients with OHS and obstructive sleep apnea (OSA) with comparable body mass index (BMI) and apnea-hypopnea index (AHI).
Positive Airway Pressure (PAP)-therapy improved Sleep Apnea Indicator (SAI), unstable sleep and Periodicity (eLFCNB) in both groups. Periodicity correlated with hs-troponin-T (p<0.05) in the combined cohort.
PAP-therapy improves CPC-derived sleep stability and heart rate variability in both OHS and OSA-patients. The serum biomarker hs-troponin-T, a marker of early subclinical cardiac disease, correlating with Periodicity suggests that in this obese population with OSA. The Periodicity-biomarker related to early subclinical cardiac disease in OHS-patients in this study, has previously been associated with hypertension, stroke risk and worsening of heart failure. Low awake oxygen saturation demonstrated an inverse relationship with hs-troponin-T in the OHS-group, suggesting that poor daytime oxygen saturation may be associated with early subclinical cardiac disease in OHS-patients, who had worse awake oxygen saturation compared to patients with OSA. For improved cardiac outcomes in this population, improvements of CPC-sleep stability and Periodicity should improve cardiac outcomes.