PMU-Autor/inn/enFicker Joachim H.
Background: Sleep-related breathing disorders may promote cardiovascular (CV) diseases. A novel and differentiated approach to overnight photoplethysmographic pulse wave analysis, which includes risk assessment and measurement of various pulse wave characteristics, has been evaluated in obstructive sleep apnea (OSA).Objectives: The purpose of this study was to assess if and which of the differentiated pulse wave characteristics might be influenced by OSA treatment with positive airway pressure (PAP).Methods: The study included two protocols. In the case-control study (group A), pulse wave-derived CV risk indices recorded during PAP therapy were compared with those obtained in age, body mass index, and CV risk class-matched patients with untreated OSA (n = 67/67). In the prospective PAP treatment study (group B), 17 unselected patients undergoing a full-night sleep test at baseline and after 23 +/- 19 weeks of treatment were analyzed. Results: In untreated OSA patients (group A), the overnight hypoxic load was increased (SpO(2) index 38.7 +/- 17.5 vs. 24.0 +/- 11.1, p < 0.001) and the pulse wave attenuation index (PWA-I) was lower (29.4 +/- 9.2 vs. 33.5 +/- 11.8, p = 0.022) than in treated patients. In group B, PAP therapy reduced the hypoxic load and increased the PWA-I significantly. The composite CV risk index was slightly but not significantly reduced. Conclusions: PAP therapy modified the hypoxic load and pulse wave-derived markers. The PWA-I - associated with sympathetic vascular tone - was most prominently modified by PAP. This novel approach to markers of CV function should be further evaluated in prospective studies. (C) 2016 S. Karger AG, Basel
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