Journal article
Effect of Obstructive Sleep Apnea and Positive Airway Pressure Therapy on Cardiac Remodeling as Assessed by Cardiac Biomarker and Magnetic Resonance Imaging in Nonobese and Obese Adults
Hypertension (Dallas, Tex. 1979), Vol.77(3), pp.980-992
03/03/2021
DOI: 10.1161/HYPERTENSIONAHA.120.15882
PMCID: PMC7878363
PMID: 33461313
Abstract
It is unknown whether obesity modifies the effect of obstructive sleep apnea (OSA) and positive airway pressure (PAP) therapy on cardiac remodeling and NT-proBNP (N-terminal pro-B-type natriuretic peptide) levels. We compared NT-proBNP and cardiac magnetic resonance imaging in adults without OSA (n=56) and nonobese (n=73; body mass index <30 kg/m2) and obese (n=136; body mass index ≥30 kg/m2) adults with OSA. We also investigated these traits in nonobese (n=45) and obese (n=78) participants with OSA adherent to 4 months of PAP treatment. At baseline, left ventricular mass to end-diastolic volume ratio, a measure of left ventricular concentricity, was greater in both nonobese and obese participants with OSA compared with those without OSA. Participants with OSA and obesity exhibited reduced phasic right atrial function. No significant differences in baseline NT-proBNP were observed across groups. The effect of PAP treatment on NT-proBNP and left atrial volume index was significantly modified by obesity. In nonobese participants, PAP therapy was associated with a decrease in NT-proBNP (P<0.0001) without a change in left atrial volume index, whereas in obese participants, PAP was associated with an increase in left atrial volume index (P=0.006) without a change in NT-proBNP. OSA was associated with left ventricular concentric remodeling independent of obesity and right atrial dysfunction in participants who were obese. PAP treatment was associated with reduced NT-proBNP in nonobese participants with OSA, but left atrial enlargement in obese participants with OSA, suggesting that PAP-induced reduction in BNP release (which is known to occur during obstructive apnea episodes) may lead to volume retention in obese participants with OSA.
Details
- Title: Subtitle
- Effect of Obstructive Sleep Apnea and Positive Airway Pressure Therapy on Cardiac Remodeling as Assessed by Cardiac Biomarker and Magnetic Resonance Imaging in Nonobese and Obese Adults
- Creators
- Liyue Xu - Peking UniversityBrendan T. Keenan - University of PennsylvaniaDavid Maislin - University of PennsylvaniaThorarinn Gislason - University of IcelandBryndís Benediktsdóttir - University of IcelandSigrun Gudmundsdóttir - National University Hospital of IcelandMarianna Gardarsdottir - National University Hospital of IcelandBethany Staley - University of PennsylvaniaFrances M. Pack - University of PennsylvaniaXiaofeng Guo - University of PennsylvaniaYuan Feng - Nanfang HospitalJugal Chahwala - University of PennsylvaniaPritika Manaktala - University of PennsylvaniaAnila Hussein - University of PennsylvaniaMaheshwara Reddy-Koppula - University of PennsylvaniaZeba Hashmath - University of PennsylvaniaJonathan Lee - University of PennsylvaniaRaymond R. Townsend - University of PennsylvaniaRichard J. Schwab - University of PennsylvaniaAllan I. Pack - University of PennsylvaniaSamuel T. Kuna - Veterans Health AdministrationJulio A. Chirinos - University of Pennsylvania
- Resource Type
- Journal article
- Publication Details
- Hypertension (Dallas, Tex. 1979), Vol.77(3), pp.980-992
- DOI
- 10.1161/HYPERTENSIONAHA.120.15882
- PMID
- 33461313
- PMCID
- PMC7878363
- NLM abbreviation
- Hypertension
- ISSN
- 0194-911X
- eISSN
- 1524-4563
- Number of pages
- 13
- Grant note
- R01AG058969 / National Institute on Aging (http://data.elsevier.com/vocabulary/SciValFunders/100000049) Microsoft (http://data.elsevier.com/vocabulary/SciValFunders/100004318) 174067-051 / Icelandic Centre for Research (http://data.elsevier.com/vocabulary/SciValFunders/501100001840) Bristol-Myers Squibb (http://data.elsevier.com/vocabulary/SciValFunders/100002491) Fukuda-Denshi National Institutes of Health (http://data.elsevier.com/vocabulary/SciValFunders/100000002) R03HL146874; R01HL121510; R01HL104106; P01HL094307; R61HL146390; R56HL136730 / National Heart, Lung, and Blood Institute (http://data.elsevier.com/vocabulary/SciValFunders/100000050) China Association for Science and Technology (http://data.elsevier.com/vocabulary/SciValFunders/100010097)
- Language
- English
- Date published
- 03/03/2021
- Academic Unit
- Internal Medicine
- Record Identifier
- 9985221244602771
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