https://orcid.org/0000-0002-5352-9587
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Abstract
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in Overlap Syndrome (OS), the co-occurrence of Obstructive Sleep Apnea and Chronic Obstructive Pulmonary Disease. Clustering of patients in subgroups with similar pre-clinical manifestations (ie, endothelial dysfunction) may identify relevant therapeutic phenotype categories for patients with OS who are at high risk of CVD. We therefore conducted a cross-sectional pilot study of endothelial function in 7 patients with OS (Forced Expiratory Volume in 1 second/Forced Vital Capacity < 0.7) on continuous positive airway pressure therapy (n = 7) to assess the relationship between FMD and physical activity. We found a strong association between FMD and step counts (rho = 0.77, p = 0.04); and FMD and moderate physical activity (rho = 0.9, p = 0.005). Further, larger studies are needed to confirm that FMD may identify patients with OS at high risk of CVD who benefit from increased physical activity.
Abbreviations
AHI, Apnea Hypopnea Index; COPD, Chronic Obstructive Pulmonary Disease; CPAP, Continuous Positive Airway Pressure; CPET, Cardiopulmonary Exercise Testing; CVD, Cardiovascular Disease; FMD, Flow mediation dilatation; mMRC, Modified Medical Research Council Dyspnea Scale; OS, Overlap Syndrome; OSA, Obstructive Sleep Apnea; PA, Physical Activity; Q-LES-Q-SF, Quality of Life Enjoyment and Satisfaction Questionnaire Short Form; VAMC, Veterans Affairs Medical Center.
Disclosure
Dr Atul Malhotra reports philanthropic donation from ResMEd to UCSD; personal fees from Jazz, Livanova, Eli Lilly, and Zoll, during the conduct of the study. The authors report no other conflicts of interest in this work.