CMR-based aortic stiffness parameters in a symptomatic high risk obstructive sleep apnea cohort: results from the population-based Hamburg City Health Study

Abstract

Aortic stiffness (AS) parameters as pulse wave velocity (PWV), aortic distensibility of the ascending and descending aorta (AD AoAsc, AD AoDesc) and pulse pressure (PP) are marker for vascular ageing, whereas data concerning obstructive sleep apnea (OSA) in population-based cohorts are sparse. Thus, we aimed to identify possible associations of AS with OSA in the Hamburg City Health Study (HCHS) cardiovascular magnetic resonance (CMR) cohort. HCHS is a population-based cohort-study quantifying PWV and AD by 2D-phase-contrast-CMR-measuring-methods and PP by blood pressure. OSA was defined as self-reported OSA by HCHS-study-interviews and/or a combination of snoring, respiratory arrest and Epworth-Sleepiness-Scale (ESS) > 10. Logistic regression analyses with adjustments were performed. In the cohort of 1,498 participants (median age 66 years, 39.0% female), 143 (9.5%) participants were identified as symptomatic high risk OSA cohort with significantly higher rates of males (p < 0.001), hypertension (p < 0.001), and coronary artery disease (p = 0.037). Median PWV and AD (p = 0.741, p = 0.145, p = 0.191) were not significantly different, but median PP was significantly higher in this OSA cohort (p = 0.003). In male OSA participants, median AD AoAsc and AD AoDesc were significantly lower and median PP significantly higher (p = 0.006, p = 0.015, p < 0.001). After adjustment for age, sex, cardiovascular risk factors (CVRF), diseases (CVD) and antihypertensive medication, OSA remained significantly associated with PP (p = 0.045), but not with PWV, AD AoAsc and AD AoDesc (p = 0.633, p = 0.503, p = 0.171). Higher PP was associated with OSA after adjustment for age, sex, CVRF, CVD and medication. Therefore, PP might be used to identify individuals at risk for OSA. The study has been registered at ClinicalTrial.gov (NCT03934957), retrospectively registered at 01/04/2019.