| Objectives:Current studies have found a correlation between hypertrophic cardiomyopathy(HCM)and obstructive sleep apnea(OSA).There was a foreign study has tried to find predictors to identify the risk of OSA in HCM patients,but no typical characteristics have been found to help identify OSA.In this regard,we analyzed the population characteristics of patients with HCM(with or without OSA)and tried to find relevant indicators to identify the risk of OSA in patients with HCM.Methods:1.Seventy-one patients with hypertrophic cardiomyopathy diagnosed in the second affiliated hospital of Nanchang university from January 2015 to December2019 were selected for polysomnography monitoring(PSG).According to the results,they were divided into 37 patients in the HCM combined OSA group and 34 patients in the HCM alone group.2.Baseline data of the two groups were collected,including blood biochemical indicators: liver and kidney function,blood glucose and lipid;cardiac color doppler ultrasound and dynamic electrocardiogram data;The patient’s age,smoking status,body mass index,combined disease history and medication status.Results:1.The incidence of HCM combined with OSA was 52%(37/71).Compared with the HCM group alone,the BMI of the HCM combined OSA group was significantly larger(25.02±3.47 VS 22.50±3.53,P=0.003),the AHI index were lager(29.04±9.86 VS 7.40±3.75,P<0.001),and the lowest blood oxygen saturation at night were lower(80.89 ± 7.50 VS 87.29 ±4.96,P<0.001),creatinine values were higher[93.96(72.60,124.21)VS 74.09(64.25,89.90),P=0.002],eGFR values were lower(72.26±23.48 VS 90.23 ± 19.17,P=0.001),SBP values were higher(134.76±26.97VS119.94±19.22,P=0.009),and the diameter of the ascending aorta was widened(32.49±4.00 VS 30.50±4.18,P=0.045).2.Univariate and multivariate logistic regression analysis using HCM combined with OSA showed that BMI(OR=1.228,95%CI: 1.032,1.461,P=0.020)and eGFR(OR=0.959,95%CI: 0.931,0.989,P=0.007)were independent risk factors for the occurrence of OSA in HCM.3.For this purpose,we planned to conduct predictive analysis of BMI and eGFR values of patients in combination,and calculated and analyzed the area under the ROC curve of BMI,eGFR and the combined two groups of data,which were0.683,0.700 and 0.785,respectively.The corresponding sensitivity and specificity were respectively 0.865,0.471;0.559,0.757;0.595,0.912.4.After dichotomous classification of BMI and eGFR data,interactive analysis was conducted.The multiplicative interactions showed that the combination of the BMI and eGFR data(i.e.,increased BMI and decreased eGFR)were statistically significant in the risk of OSA in HCM patients compared with patients without this condition(OR: 6.050,95%CI: 1.598,22.905,P=0.008),and the effect persisted after adjusting for different confounding factors.The additive interaction results showed that the AP value(0.701,95%CI: 0.221,1.181),suggested that 70.1% of HCM patients developed OSA due to the biological interaction between BMI and eGFR,and the AP value was more significant after adjusting for related confounding factors(0.714,95%CI: 0.256,1.178).Conclusions:For patients with HCM combined with OSA,there were biological interactions between BMI and eGFR,including multiplication and addition interactions.When BMI combined with eGFR was used to predict the risk of OSA in HCM,the specificity was higher. |
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