Abstract：
OBJECTIVE: This study investigated the impact of APAP therapy on vascular behavior and its potential to lower cardiovascular risk in patients with OSA, as well as differentiating APAP therapy heterogeneity.
METHODS: All participants were diagnosed with OSA by portable monitoring, and pulse wave parameters and cardiac risk composite parameter index (CRI) were obtained by photoplethysmography before and after APAP. Clustering analysis of pulse wave parameters before APAP in the high-risk population was performed using k-means clustering. Linear regression was used to assess the associations of changes in CRI and pulse wave parameters with clinical characteristics.
RESULTS: Eighty-two patients with OSA underwent APAP therapy. The CRI after APAP was significantly lower than before APAP (0.38± 0.33 and 0.58 ± 0.31, respectively; p < 0.001). All pulse wave parameters (except irregular pulse) were significantly different (p < 0.001) in patients with OSA and in the high-risk responders group after versus before APAP. The differences in pulse wave parameters after versus before APAP were not significant in the high-risk non-responders group, except for RCRD and pulse rate variability. Four clusters were obtained from the clustering analysis of pulse wave parameters before APAP in the high-risk responders group.
CONCLUSIONS: APAP reduces the CRI in patients with OSA by altering vascular behavior. Overnight photoplethysmography monitoring of pulse wave parameters can be used to assess whether patients with OSA will benefit from APAP.
METHODS: All participants were diagnosed with OSA by portable monitoring, and pulse wave parameters and cardiac risk composite parameter index (CRI) were obtained by photoplethysmography before and after APAP. Clustering analysis of pulse wave parameters before APAP in the high-risk population was performed using k-means clustering. Linear regression was used to assess the associations of changes in CRI and pulse wave parameters with clinical characteristics.
RESULTS: Eighty-two patients with OSA underwent APAP therapy. The CRI after APAP was significantly lower than before APAP (0.38± 0.33 and 0.58 ± 0.31, respectively; p < 0.001). All pulse wave parameters (except irregular pulse) were significantly different (p < 0.001) in patients with OSA and in the high-risk responders group after versus before APAP. The differences in pulse wave parameters after versus before APAP were not significant in the high-risk non-responders group, except for RCRD and pulse rate variability. Four clusters were obtained from the clustering analysis of pulse wave parameters before APAP in the high-risk responders group.
CONCLUSIONS: APAP reduces the CRI in patients with OSA by altering vascular behavior. Overnight photoplethysmography monitoring of pulse wave parameters can be used to assess whether patients with OSA will benefit from APAP.
摘要：
目的：本研究调查了APAP治疗对OSA患者血管行为的影响及其降低心血管风险的潜力，以及区分APAP治疗异质性。
方法：所有参与者均通过便携式监测诊断为OSA，在APAP前后通过光电容积描记术获得脉搏波参数和心脏风险综合参数指数（CRI）。采用k-means聚类对高危人群APAP前脉搏波参数进行聚类分析。线性回归用于评估CRI和脉搏波参数变化与临床特征的关联。
结果：82例OSA患者接受了APAP治疗。APAP后CRI显著低于APAP前(分别为0.38±0.33和0.58±0.31;p<0.001)。与APAP之前相比，OSA患者和高危反应者组的所有脉搏波参数（不规则脉搏除外）均存在显着差异（p<0.001）。在高风险无应答者组中，APAP后与前的脉搏波参数差异不显著，除了RCRD和脉搏率变异性。从高危反应者组APAP前脉搏波参数的聚类分析中获得了四个聚类。
结论：APAP通过改变血管行为降低OSA患者的CRI。脉搏波参数的过夜光电容积描记术监测可用于评估OSA患者是否会从APAP中受益。
方法：所有参与者均通过便携式监测诊断为OSA，在APAP前后通过光电容积描记术获得脉搏波参数和心脏风险综合参数指数（CRI）。采用k-means聚类对高危人群APAP前脉搏波参数进行聚类分析。线性回归用于评估CRI和脉搏波参数变化与临床特征的关联。
结果：82例OSA患者接受了APAP治疗。APAP后CRI显著低于APAP前(分别为0.38±0.33和0.58±0.31;p<0.001)。与APAP之前相比，OSA患者和高危反应者组的所有脉搏波参数（不规则脉搏除外）均存在显着差异（p<0.001）。在高风险无应答者组中，APAP后与前的脉搏波参数差异不显著，除了RCRD和脉搏率变异性。从高危反应者组APAP前脉搏波参数的聚类分析中获得了四个聚类。
结论：APAP通过改变血管行为降低OSA患者的CRI。脉搏波参数的过夜光电容积描记术监测可用于评估OSA患者是否会从APAP中受益。
