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. 2024 Dec 28:16:2279-2288.
doi: 10.2147/NSS.S494018. eCollection 2024.

Association Between Nocturnal Hypoxemia Parameters and Coronary Microvascular Dysfunction: A Cross-Sectional Study

Lanxin Feng  1 , Xin Zhao  1 , Jianqiao Song  2 , Shuwen Yang  1 , Jianping Xiang  3 , Min Zhang  1 , Chenchen Tu  1 , Xiantao Song  1
Affiliations

Association Between Nocturnal Hypoxemia Parameters and Coronary Microvascular Dysfunction: A Cross-Sectional Study

Lanxin Feng et al. Nat Sci Sleep. .

Abstract

Objective: There is a connection between obstructive sleep apnea (OSA) and coronary microvascular dysfunction (CMD), but the underlying mechanisms remain unclear. This study aims to evaluate the correlation between OSA-related nocturnal hypoxemia parameters and CMD.

Methods: This is an observational, single-center study that included patients who underwent polysomnography and coronary angiography during hospitalization. The presence of CMD was determined by angio-based index of microcirculatory resistance (AccuIMR). Categorical variables were compared using chi-square test or Fisher exact test. The t-test and Mann-Whitney U-test were used to compare normally and non-normally distributed continuous variables, respectively. Univariate and multivariable logistic regression analyses were performed to evaluate the relationship between nocturnal hypoxemia parameters and CMD.

Results: A total of 133 patients were included in this study, of whom 72 (54.14%) had evidence of CMD. Patients with CMD exhibited a higher prevalence of OSA and experienced more severe nocturnal hypoxia. After adjusting for potential confounding factors, minimum oxygen saturation (minSpO2) ≤90% (OR 5.89; 95% CI 1.73-19.99; P=0.004) and the percentage of time spent with oxygen saturation below 90% (T90) ≥5% (OR 3.13; 95% CI 1.05-9.38; P=0.041) were independently associated with CMD. However, no significant association was observed between apnea-hypopnea index (AHI) and CMD.

Conclusion: Parameters of nocturnal hypoxemia are associated with CMD. Hypoxemia parameters may more sensitively reflect the correlation between OSA and CMD than AHI.

Keywords: cardiology; coronary microvascular dysfunction; dentistry; nocturnal hypoxemia; obstructive sleep apnea.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flowchart of patient enrollment in the study.
Figure 2
Figure 2
Schematic diagram of AccuIMR calculation. (A) The coronary angiogram. (B and C) Angiograms from 2 projections with automatically delineated lumen contour. (D) Lumen diameter and computed FFR (AccuFFRangio) pullback. (E) Computed AccuIMR value. Abbreviations: AccuIMR, angio-based index of microcirculatory resistance; FFR, fractional flow reserve.
Figure 3
Figure 3
Comparison of the severity of hypoxemia between patients in different AccuIMR levels. The proportions of patients with (A) minSpO2≤90% (B) minSpO2≤80% (C) T90≥5% (D) T90≥10%. Abbreviations: AccuIMR, angio-based index of microcirculatory resistance; minSpO2, minimal oxygen saturation; T90, the percentage of time spent with SpO2 below 90%.
Figure 4
Figure 4
Univariate and multivariable logistic analysis for coronary microvascular dysfunction defined by AccuIMR.
See this image and copyright information in PMC

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