A27-12 Hypobaric and Intermittent Hypoxia Amplify Cardiac Stress in Pediatric Obstructive Sleep Apnea

Abstract Background Pediatric obstructive sleep apnea (OSA) has been linked to systemic inflammation and cardiovascular remodeling. The objective was to evaluate the association between OSA severity, nocturnal hypoxemia, and cardiovascular abnormalities, assessed by serum proBNP levels and echocardiographic parameters, in children living at 2640 m above sea level. Methods A cross-sectional analytical study was conducted with 309 children aged 5-16 years from a pediatric respiratory medicine referral center in Bogotá, Colombia. OSA was diagnosed by complete polysomnography. Serum biomarkers and transthoracic echocardiography were obtained simultaneously. Associations were examined using Spearman correlations, multiple linear regression, and logistic models adjusted for age, sex, BMI, and asthma diagnosis. Results OSA was observed in 213 children (69%). Median proBNP levels were higher in children with OSA than in those without (0.55 vs. 0.39 pg/mL; P = .05). ProBNP correlated with the oxygen desaturation index (ρ = 0.21; P .01). In multivariate analysis, the desaturation index (β = 0.013; P = .002) and the presence of OSA (β = 0.191; P = .034) independently predicted higher proBNP levels. T90 was associated with larger left ventricular diameters in diastole (P = .07) and systole (P = .02). Increased pulmonary artery diameter was associated with higher AHI, AHI-O, and desaturation index (P .01). IL-10 levels were significantly lower in OSA (p = 0.04). Conclusions In children living at high altitude, OSA was associated with elevated proBNP levels and mild echocardiographic changes consistent with subclinical cardiac stress. Combined exposure to intermittent and hypobaric hypoxia may potentiate cardiovascular stress, underscoring the need for early detection strategies for this condition. This abstract is funded by: None