Key result
Obesity is linked to ~76% higher odds of an HFpEF-like phenotype in revascularized CAD.
Why the study?
HFpEF is closely linked to aging and cardiometabolic risk factors and frequently coexists with OSA, prompting investigation into the prevalence and clinical correlates of an HFpEF-like phenotype in revascularized CAD, focusing on OSA severity.
Does obstructive sleep apnea independently associate with an HFpEF-like cardiac remodeling phenotype beyond aging and obesity in patients with revascularized coronary artery disease and preserved ejection fraction?
Cross-Sectional (n=435)
No
Does obstructive sleep apnea independently associate with an HFpEF-like cardiac remodeling phenotype beyond aging and obesity in patients with revascularized coronary artery disease and preserved ejection fraction?
In patients with revascularized CAD and preserved ejection fraction, an HFpEF-like remodeling phenotype is highly prevalent (69.9%) and is driven primarily by aging and obesity rather than an independent effect of obstructive sleep apnea.
BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) is closely linked to aging and cardiometabolic risk factors and frequently coexists with obstructive sleep apnea (OSA). We aimed to investigate the prevalence and clinical correlates of an HFpEF-like phenotype in a revascularized coronary artery disease (CAD cohort), focusing on OSA and its severity. METHODS: A total of 435 patients with preserved left ventricular ejection fraction from the RICCADSA cohort were included. OSA was defined as apnea-hypopnea index (AHI) ≥ 15 events/h. HFpEF-like phenotype was defined by ≥ 2 of the following: elevated filling pressures (E/e' ≥ 15), left atrial enlargement, increased left ventricular mass index, elevated pulmonary artery systolic pressure (≥ 35 mmHg), and elevated NT-proBNP (≥ 125 pg/mL). Multivariable logistic regression analyses included age, sex, obesity, hypertension, diabetes, and OSA status. Additional models evaluated AHI and oxygen desaturation index (ODI) as continuous variables and assessed the impact of excluding body mass index (BMI). RESULTS: ; 69.9% met HFpEF-like criteria. Age and obesity were independently associated with HFpEF-like phenotype, whereas categorical OSA was not. AHI and ODI were not independently associated after adjustment; however, in models excluding BMI, both AHI (OR 1.019, 95% CI 1.005-1.033) and ODI (OR 1.030, 95% CI 1.010-1.050) were significant predictors. CONCLUSIONS: HFpEF-like phenotype is highly prevalent in CAD and primarily associated with aging and adiposity. The relationship between OSA severity and cardiac remodeling appears dependent on obesity, underscoring the interplay between cardiometabolic and sleep-related factors. PRE-REGISTERED CLINICAL TRIAL NUMBER: The RICCADSA trial is registered at ClinicalTrials.gov (NCT00519597) and in the Swedish national research registry (FoU i Sverige-Research and Development in Sweden; registration no. VGSKAS-4731; April 29, 2005).
No takes yet. Share an insight, caveat, or question.
Thunström et al. (2026) conducted a cross-sectional in Revascularized coronary artery disease with preserved left ventricular ejection fraction (n=435). Obstructive sleep apnea (AHI ≥ 15 events/h), age, and obesity (BMI ≥ 30 kg/m2) vs. No obstructive sleep apnea (AHI < 15 events/h), younger age (< 50 years), and non-obese status (BMI < 30 kg/m2) was evaluated on HFpEF-like phenotype (≥2 of: septal E/e' ≥15, left atrial enlargement, increased LVMI, pulmonary artery systolic pressure ≥35 mmHg, or NT-proBNP ≥125 pg/mL) (OR 1.76, 95% CI 1.01-3.06, p=0.045). Obesity (OR 1.76, 95% CI 1.01-3.06) and age, rather than obstructive sleep apnea, were independently associated with an HFpEF-like phenotype in patients with revascularized CAD.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: