Lung to finger circulation time in sleep study and coronary artery calcification: the Multi-Ethnic Study of Atherosclerosis

Younghoon Kwon; Sara Mariani; Michelle Reid; David Jacobs; Joao Lima; Vishesh Kapur; Naresh Punjabi; Susan Redline

doi:10.1016/j.sleep.2020.05.033

Lung to finger circulation time in sleep study and coronary artery calcification: the Multi-Ethnic Study of Atherosclerosis

Younghoon Kwon, Sara Mariani, Michelle Reid, David Jacobs, Joao Lima, Vishesh Kapur, Naresh Punjabi, Susan Redline

Epidemiology & Community Health

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

Background: Lung to finger circulation time (LFCT) measured from sleep studies may represent a novel physiologic marker for cardiovascular risk in patients with sleep disordered breathing (SDB). We hypothesized that sleep study-derived LFCT would improve risk classification of markers of subclinical cardiovascular disease. Methods: We included participants in the Multi-Ethnic Study of Atherosclerosis (MESA) Sleep cohort with moderate-severe SDB (apnea hypopnea index [AHI] ≥ 15/hr) (N = 598). Results: Those with average LFCT above the median (19.4 s) (vs. shorter LFCT) tended to be older, more obese and male. In multivariable analysis, no significant associations were found between average LFCT and subclinical cardiovascular markers including coronary artery calcium, carotid intima-media thickness or left ventricular hypertrophy. However, there was modest improvement in risk classification of coronary artery calcification as compared with AHI alone when average LFCT was added to AHI (C statistics 0.53 vs. 0.62, p = 0.0066). Conclusions: In conclusion, LFCT may be a useful addition to conventional SDB metrics to improve cardiovascular risk assessment.

Original language	English (US)
Pages (from-to)	8-11
Number of pages	4
Journal	Sleep Medicine
Volume	75
DOIs	https://doi.org/10.1016/j.sleep.2020.05.033
State	Published - Nov 2020

Bibliographical note

Funding Information:
This work was supported by N01-HC-95159 , N01-HC-95160 , N01-HC-95161 , N01-HC-95162 , N01-HC-95163 , N01-HC-95164 , N01-HC-95165 , N01-HC-95166 , N01-HC-95167 , N01-HC-95168 and N01-HC-95169 from the NHBLI , by grants UL1-TR-000040 , UL1-RR-025005 from NCRR , R01HL098433 (MESA Sleep), R35HL135818, R21HL140432 and AASM 162-FP-17. This publication was also developed under a STAR research assistance agreements, No. RD831697 (MESA Air) and RD-83830001 (MESA Air Next Stage), awarded by the U.S Environmental Protection Agency. It has not been formally reviewed by the EPA. The views expressed in this document are solely those of the authors and the EPA does not endorse any products or commercial services mentioned in this publication.

Funding Information:
This work was supported by N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168 and N01-HC-95169 from the NHBLI, by grants UL1-TR-000040, UL1-RR-025005 from NCRR, R01HL098433 (MESA Sleep), R35HL135818, R21HL140432 and AASM 162-FP-17. This publication was also developed under a STAR research assistance agreements, No. RD831697 (MESA Air) and RD-83830001 (MESA Air Next Stage), awarded by the U.S Environmental Protection Agency. It has not been formally reviewed by the EPA. The views expressed in this document are solely those of the authors and the EPA does not endorse any products or commercial services mentioned in this publication.

Publisher Copyright:
© 2020 Elsevier B.V.

Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.

Keywords

Atherosclerosis
Cardiovascular
Circulation
Coronary artery calcium
Polysomnography
Sleep apnea

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.sleep.2020.05.033

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@article{dac0c73c1ac94d68a5f7b0a7c1fe5a67,

title = "Lung to finger circulation time in sleep study and coronary artery calcification: the Multi-Ethnic Study of Atherosclerosis",

abstract = "Background: Lung to finger circulation time (LFCT) measured from sleep studies may represent a novel physiologic marker for cardiovascular risk in patients with sleep disordered breathing (SDB). We hypothesized that sleep study-derived LFCT would improve risk classification of markers of subclinical cardiovascular disease. Methods: We included participants in the Multi-Ethnic Study of Atherosclerosis (MESA) Sleep cohort with moderate-severe SDB (apnea hypopnea index [AHI] ≥ 15/hr) (N = 598). Results: Those with average LFCT above the median (19.4 s) (vs. shorter LFCT) tended to be older, more obese and male. In multivariable analysis, no significant associations were found between average LFCT and subclinical cardiovascular markers including coronary artery calcium, carotid intima-media thickness or left ventricular hypertrophy. However, there was modest improvement in risk classification of coronary artery calcification as compared with AHI alone when average LFCT was added to AHI (C statistics 0.53 vs. 0.62, p = 0.0066). Conclusions: In conclusion, LFCT may be a useful addition to conventional SDB metrics to improve cardiovascular risk assessment.",

keywords = "Atherosclerosis, Cardiovascular, Circulation, Coronary artery calcium, Polysomnography, Sleep apnea",

author = "Younghoon Kwon and Sara Mariani and Michelle Reid and David Jacobs and Joao Lima and Vishesh Kapur and Naresh Punjabi and Susan Redline",

note = "Funding Information: This work was supported by N01-HC-95159 , N01-HC-95160 , N01-HC-95161 , N01-HC-95162 , N01-HC-95163 , N01-HC-95164 , N01-HC-95165 , N01-HC-95166 , N01-HC-95167 , N01-HC-95168 and N01-HC-95169 from the NHBLI , by grants UL1-TR-000040 , UL1-RR-025005 from NCRR , R01HL098433 (MESA Sleep), R35HL135818, R21HL140432 and AASM 162-FP-17. This publication was also developed under a STAR research assistance agreements, No. RD831697 (MESA Air) and RD-83830001 (MESA Air Next Stage), awarded by the U.S Environmental Protection Agency. It has not been formally reviewed by the EPA. The views expressed in this document are solely those of the authors and the EPA does not endorse any products or commercial services mentioned in this publication. Funding Information: This work was supported by N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168 and N01-HC-95169 from the NHBLI, by grants UL1-TR-000040, UL1-RR-025005 from NCRR, R01HL098433 (MESA Sleep), R35HL135818, R21HL140432 and AASM 162-FP-17. This publication was also developed under a STAR research assistance agreements, No. RD831697 (MESA Air) and RD-83830001 (MESA Air Next Stage), awarded by the U.S Environmental Protection Agency. It has not been formally reviewed by the EPA. The views expressed in this document are solely those of the authors and the EPA does not endorse any products or commercial services mentioned in this publication. Publisher Copyright: {\textcopyright} 2020 Elsevier B.V. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.",

year = "2020",

month = nov,

doi = "10.1016/j.sleep.2020.05.033",

language = "English (US)",

volume = "75",

pages = "8--11",

journal = "Sleep Medicine",

issn = "1389-9457",

publisher = "Elsevier",

}

TY - JOUR

T1 - Lung to finger circulation time in sleep study and coronary artery calcification

T2 - the Multi-Ethnic Study of Atherosclerosis

AU - Kwon, Younghoon

AU - Mariani, Sara

AU - Reid, Michelle

AU - Jacobs, David

AU - Lima, Joao

AU - Kapur, Vishesh

AU - Punjabi, Naresh

AU - Redline, Susan

N1 - Funding Information: This work was supported by N01-HC-95159 , N01-HC-95160 , N01-HC-95161 , N01-HC-95162 , N01-HC-95163 , N01-HC-95164 , N01-HC-95165 , N01-HC-95166 , N01-HC-95167 , N01-HC-95168 and N01-HC-95169 from the NHBLI , by grants UL1-TR-000040 , UL1-RR-025005 from NCRR , R01HL098433 (MESA Sleep), R35HL135818, R21HL140432 and AASM 162-FP-17. This publication was also developed under a STAR research assistance agreements, No. RD831697 (MESA Air) and RD-83830001 (MESA Air Next Stage), awarded by the U.S Environmental Protection Agency. It has not been formally reviewed by the EPA. The views expressed in this document are solely those of the authors and the EPA does not endorse any products or commercial services mentioned in this publication. Funding Information: This work was supported by N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168 and N01-HC-95169 from the NHBLI, by grants UL1-TR-000040, UL1-RR-025005 from NCRR, R01HL098433 (MESA Sleep), R35HL135818, R21HL140432 and AASM 162-FP-17. This publication was also developed under a STAR research assistance agreements, No. RD831697 (MESA Air) and RD-83830001 (MESA Air Next Stage), awarded by the U.S Environmental Protection Agency. It has not been formally reviewed by the EPA. The views expressed in this document are solely those of the authors and the EPA does not endorse any products or commercial services mentioned in this publication. Publisher Copyright: © 2020 Elsevier B.V. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.

PY - 2020/11

Y1 - 2020/11

N2 - Background: Lung to finger circulation time (LFCT) measured from sleep studies may represent a novel physiologic marker for cardiovascular risk in patients with sleep disordered breathing (SDB). We hypothesized that sleep study-derived LFCT would improve risk classification of markers of subclinical cardiovascular disease. Methods: We included participants in the Multi-Ethnic Study of Atherosclerosis (MESA) Sleep cohort with moderate-severe SDB (apnea hypopnea index [AHI] ≥ 15/hr) (N = 598). Results: Those with average LFCT above the median (19.4 s) (vs. shorter LFCT) tended to be older, more obese and male. In multivariable analysis, no significant associations were found between average LFCT and subclinical cardiovascular markers including coronary artery calcium, carotid intima-media thickness or left ventricular hypertrophy. However, there was modest improvement in risk classification of coronary artery calcification as compared with AHI alone when average LFCT was added to AHI (C statistics 0.53 vs. 0.62, p = 0.0066). Conclusions: In conclusion, LFCT may be a useful addition to conventional SDB metrics to improve cardiovascular risk assessment.

AB - Background: Lung to finger circulation time (LFCT) measured from sleep studies may represent a novel physiologic marker for cardiovascular risk in patients with sleep disordered breathing (SDB). We hypothesized that sleep study-derived LFCT would improve risk classification of markers of subclinical cardiovascular disease. Methods: We included participants in the Multi-Ethnic Study of Atherosclerosis (MESA) Sleep cohort with moderate-severe SDB (apnea hypopnea index [AHI] ≥ 15/hr) (N = 598). Results: Those with average LFCT above the median (19.4 s) (vs. shorter LFCT) tended to be older, more obese and male. In multivariable analysis, no significant associations were found between average LFCT and subclinical cardiovascular markers including coronary artery calcium, carotid intima-media thickness or left ventricular hypertrophy. However, there was modest improvement in risk classification of coronary artery calcification as compared with AHI alone when average LFCT was added to AHI (C statistics 0.53 vs. 0.62, p = 0.0066). Conclusions: In conclusion, LFCT may be a useful addition to conventional SDB metrics to improve cardiovascular risk assessment.

KW - Atherosclerosis

KW - Cardiovascular

KW - Circulation

KW - Coronary artery calcium

KW - Polysomnography

KW - Sleep apnea

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UR - http://www.scopus.com/inward/citedby.url?scp=85089704555&partnerID=8YFLogxK

U2 - 10.1016/j.sleep.2020.05.033

DO - 10.1016/j.sleep.2020.05.033

M3 - Article

C2 - 32841914

AN - SCOPUS:85089704555

SN - 1389-9457

VL - 75

SP - 8

EP - 11

JO - Sleep Medicine

JF - Sleep Medicine

ER -

Lung to finger circulation time in sleep study and coronary artery calcification: the Multi-Ethnic Study of Atherosclerosis

Abstract

Bibliographical note

Keywords

UN SDGs

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