Juan F Masa1, Jaime Corral2, Auxiliadora Romero3, Candela Caballero3, Joaquin Terán-Santos4, Maria L Alonso-Álvarez4, Teresa Gomez-Garcia5, Mónica González6, Soledad López-Martín7, Pilar De Lucas7, José M Marin8, Sergi Marti9, Trinidad Díaz-Cambriles10, Eusebi Chiner11, Miguel Merchan12, Carlos Egea13, Ana Obeso14, Babak Mokhlesi15. 1. San Pedro de Alcántara Hospital, Cáceres, Spain; CIBER de Enfermedades Respiratorias, Madrid, Spain. Electronic address: fmasa@separ.es. 2. San Pedro de Alcántara Hospital, Cáceres, Spain; CIBER de Enfermedades Respiratorias, Madrid, Spain. 3. Virgen del Rocío Hospital, Sevilla, Spain. 4. University Hospital, Burgos, Spain; CIBER de Enfermedades Respiratorias, Madrid, Spain. 5. IIS Fundación Jiménez Díaz, Madrid, Spain. 6. Valdecilla Hospital, Santander, Spain. 7. Gregorio Marañon Hospital, Madrid, Spain. 8. Miguel Servet Hospital, Zaragoza, Spain; CIBER de Enfermedades Respiratorias, Madrid, Spain. 9. Valld'Hebron Hospital, Barcelona, Spain; CIBER de Enfermedades Respiratorias, Madrid, Spain. 10. Doce de Octubre Hospital, Madrid, Spain; CIBER de Enfermedades Respiratorias, Madrid, Spain. 11. San Juan Hospital, Alicante, Spain. 12. San Pedro de Alcántara Hospital, Cáceres, Spain. 13. Sleep Unit, Respiratory Department, Alava University Hospital, Vitoria, Spain; CIBER de Enfermedades Respiratorias, Madrid, Spain. 14. CIBER de Enfermedades Respiratorias, Madrid, Spain; Department of Biochemistry, Molecular Biology and Physiology, Faculty of Medicine, Valladolid University, Valladolid, Spain. 15. Department of Medicine, Section of Pulmonary and Critical Care, University of Chicago, Chicago, IL.
Abstract
BACKGROUND:Obesity hypoventilation syndrome (OHS) is associated with a high burden of cardiovascular morbidity (CVM) and mortality. The majority of patients with OHS have concomitant OSA, but there is a paucity of data on the association between CVM and OSA severity in patients with OHS. The objective of our study was to assess the association between CVM and OSA severity in a large cohort of patients with OHS. METHODS: In a cross-sectional analysis, we examined the association between OSA severity based on tertiles of oxygen desaturation index (ODI) and CVM in 302 patients with OHS. Logistic regression models were constructed to quantify the independent association between OSA severity and prevalent CVM after adjusting for various important confounders. RESULTS: The prevalence of CVM decreased significantly with increasing severity of OSA based on ODI as a continuous variable or ODI tertiles. This inverse relationship between OSA severity and prevalence of CVM was seen in the highest ODI tertile and it persisted despite adjustment for multiple confounders. Chronic heart failure had the strongest negative association with the highest ODI tertile. No significant CVM risk change was observed between the first and second ODI tertiles. Patients in the highest ODI tertile were younger, predominantly male, more obese, more hypersomnolent, had worse nocturnal and daytime gas exchange, lower prevalence of hypertension, better exercise tolerance, and fewer days hospitalized than patients in the lowest ODI tertile. CONCLUSIONS: In patients with OHS, the highest OSA severity phenotype was associated with reduced risk of CVM. This finding should guide the design of future clinical trials assessing the impact of interventions aimed at decreasing cardiovascular morbidity and mortality in patients with OHS. TRIAL REGISTRY: Clinicaltrial.gov; No.: NCT01405976; URL: www.clinicaltrials.gov.
RCT Entities:
BACKGROUND:Obesity hypoventilation syndrome (OHS) is associated with a high burden of cardiovascular morbidity (CVM) and mortality. The majority of patients with OHS have concomitant OSA, but there is a paucity of data on the association between CVM and OSA severity in patients with OHS. The objective of our study was to assess the association between CVM and OSA severity in a large cohort of patients with OHS. METHODS: In a cross-sectional analysis, we examined the association between OSA severity based on tertiles of oxygen desaturation index (ODI) and CVM in 302 patients with OHS. Logistic regression models were constructed to quantify the independent association between OSA severity and prevalent CVM after adjusting for various important confounders. RESULTS: The prevalence of CVM decreased significantly with increasing severity of OSA based on ODI as a continuous variable or ODI tertiles. This inverse relationship between OSA severity and prevalence of CVM was seen in the highest ODI tertile and it persisted despite adjustment for multiple confounders. Chronic heart failure had the strongest negative association with the highest ODI tertile. No significant CVM risk change was observed between the first and second ODI tertiles. Patients in the highest ODI tertile were younger, predominantly male, more obese, more hypersomnolent, had worse nocturnal and daytime gas exchange, lower prevalence of hypertension, better exercise tolerance, and fewer days hospitalized than patients in the lowest ODI tertile. CONCLUSIONS: In patients with OHS, the highest OSA severity phenotype was associated with reduced risk of CVM. This finding should guide the design of future clinical trials assessing the impact of interventions aimed at decreasing cardiovascular morbidity and mortality in patients with OHS. TRIAL REGISTRY: Clinicaltrial.gov; No.: NCT01405976; URL: www.clinicaltrials.gov.
Authors: Juan F Masa; Iván D Benítez; Shahrokh Javaheri; Maria Victoria Mogollon; Maria Á Sánchez-Quiroga; Francisco J Gomez de Terreros; Jaime Corral; Rocio Gallego; Auxiliadora Romero; Candela Caballero-Eraso; Estrella Ordax-Carbajo; María F Troncoso; Mónica González; Soledad López-Martín; José M Marin; Sergi Martí; Trinidad Díaz-Cambriles; Eusebi Chiner; Carlos Egea; Javier Barca; Ferrán Barbé; Babak Mokhlesi Journal: J Clin Sleep Med Date: 2022-04-01 Impact factor: 4.062
Authors: Talha Mubashir; Hunza S Ahmad; Hongyin Lai; Rabail Chaudhry; Vahed Maroufy; Julius Balogh; Biai Dominique; Ray Hwong; Frances Chung; George W Williams Journal: Neurocrit Care Date: 2022-03-31 Impact factor: 3.532
Authors: Alberto R Ramos; Pedro Figueredo; Shirin Shafazand; Alejandro D Chediak; Alexandre R Abreu; Salim I Dib; Carlos Torre; Douglas M Wallace Journal: Front Neurol Date: 2017-12-05 Impact factor: 4.003
Authors: Juan F Masa; Jaime Corral; Candela Caballero; Emilia Barrot; Joaquin Terán-Santos; Maria L Alonso-Álvarez; Teresa Gomez-Garcia; Mónica González; Soledad López-Martín; Pilar De Lucas; José M Marin; Sergi Marti; Trinidad Díaz-Cambriles; Eusebi Chiner; Carlos Egea; Erika Miranda; Babak Mokhlesi; Estefanía García-Ledesma; M-Ángeles Sánchez-Quiroga; Estrella Ordax; Nicolás González-Mangado; Maria F Troncoso; Maria-Ángeles Martinez-Martinez; Olga Cantalejo; Elena Ojeda; Santiago J Carrizo; Begoña Gallego; Mercedes Pallero; M Antonia Ramón; Josefa Díaz-de-Atauri; Jesús Muñoz-Méndez; Cristina Senent; Jose N Sancho-Chust; Francisco J Ribas-Solís; Auxiliadora Romero; José M Benítez; Jesús Sanchez-Gómez; Rafael Golpe; Ana Santiago-Recuerda; Silvia Gomez; Mónica Bengoa Journal: Thorax Date: 2016-07-12 Impact factor: 9.139
Authors: Babak Mokhlesi; Juan Fernando Masa; Jan L Brozek; Indira Gurubhagavatula; Patrick B Murphy; Amanda J Piper; Aiman Tulaimat; Majid Afshar; Jay S Balachandran; Raed A Dweik; Ronald R Grunstein; Nicholas Hart; Roop Kaw; Geraldo Lorenzi-Filho; Sushmita Pamidi; Bhakti K Patel; Susheel P Patil; Jean Louis Pépin; Israa Soghier; Maximiliano Tamae Kakazu; Mihaela Teodorescu Journal: Am J Respir Crit Care Med Date: 2019-08-01 Impact factor: 21.405
Authors: Abdelnaby Khalyfa; David Gozal; Juan F Masa; José Maria Marin; Zhuanghong Qiao; Jaime Corral; Mónica González; Sergi Marti; Leila Kheirandish-Gozal; Carlos Egea; M-Ángeles Sánchez-Quiroga; Francisco J Gómez de Terreros; F Javier Barca Journal: Int J Obes (Lond) Date: 2018-06-11 Impact factor: 5.095