Association between central sleep apnea and atrial fibrillation/flutter in Japanese-American men: The Kuakini Honolulu Heart Program (HHP) and Honolulu-Asia Aging Study (HAAS)

Anzai, Tagayasu; Grandinetti, Andrew; Katz, Alan R.; Hurwitz, Eric L.; Wu, Yan Yan; Masaki, Kamal

doi:10.1016/j.jelectrocard.2020.05.005

Cited by 13 publications

(12 citation statements)

References 33 publications

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“…A total 1523 participants were examined at the Kuakini HHP-HAAS seventh examination. Details of the selection algorism have been published in a previous paper [4] . Briefly, a total of 718 Japanese-American men between 79 and 97 years old had overnight PSG in their homes using criteria established by the large multicenter Sleep Heart Health Study (SHHS) [6] , [9] , which was a community-based prospective cohort study conducted in 1995–2006.…”

Section: Methodsmentioning

confidence: 99%

“…1 Study’s recruitment and enrollment. The Kuakini HAASSA 1999–2000 [4] , [9] and Mr.OS Sleep Study 2003–2005 [10] , [11] . ECG, Electrocardiogram; HAASSA, Honolulu-Asia Aging Study of Sleep; HAAS, Honolulu Asia Aging Study; Mr. OS, the Osteoporotic Fractures in Men Sleep Study; PSG, polysomnography.…”

Section: Methodsmentioning

confidence: 99%

“…The ascertainment method of AF was as described in our previous study [4] . In brief, AF was confirmed by a Japanese Circulation Society board-certified physician using single lead ECG of the PSG interpretation software.…”

Section: Methodsmentioning

confidence: 99%

“…AF was diagnosed according to the ACC/AHA/ESC guidelines [12] . A validation analysis to assess the accuracy of our physician’s ECG interpretations, using the 12-lead ECG data from SHHS as the gold standard, revealed the specificity and sensitivity to be 97.5% (154/158) and 93.3% (14/15) respectively [4] . Mehra et al indicated that when ECG of PSG data from the Mr.OS sleep study, which was a random sample of 20 sleep studies, were manually reviewed by two blinded electrophysiologists, the estimated correlation coefficient was 0.98 for supraventricular beats [7] .…”

Section: Methodsmentioning

confidence: 99%

“…Many studies show an association between OSA and AF [2] . Moreover, several studies recently have indicated there was an association between CSA/CSB and AF in the general population [3] , [4] , [5] , [6] , [7] . However, few studies focused on the impact on ethnicity on the association between CSA and AF even though the prevalence and characteristics of CSA vary among ethnic groups.…”

Section: Introductionmentioning

confidence: 99%

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Cross-ethnic comparison of the association between central sleep apnea and atrial fibrillation/flutter: The Kuakini Honolulu-Asia Aging Study and the Osteoporotic Fractures in Men (Mr.OS) study

Anzai

Grandinetti

Katz

et al. 2021

IJC Heart & Vasculature

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Introduction Few studies indicated the impact of ethnicity on an association between central sleep apnea (CSA) and atrial fibrillation/flutter (AF) in older populations. We assessed possible ethnic differences in the association among elderly Japanese-American and White-American men. Methods We performed a cross-sectional analysis using two population studies of Japanese-American and White-American men. The Kuakini Honolulu-Asia Aging Study is a longitudinal cohort study of Japanese-American men living in Hawaii. Sleep data were collected between 1999 and 2000. The Osteoporotic Fractures in Men (Mr.OS) Sleep Study was conducted between 2003 and 2005 on the continental U.S. The majority of Mr.OS participants were White-American. We selected 79–90 year old males, who had overnight polysomnography from both studies. Total participants were 690 Japanese-American and 871 White-American men. The central apnea index (CAI) was the measure of the number of central apneas. CSA was defined by CAI>=5. Cheyne-Stokes breathing (CSB) was defined as a minimum consecutive 5–10 min period of a crescendo-decrescendo respiratory pattern associated with CSA. Results The prevalence of AF was 5.7% in Japanese-American men and 9.0% in White-American men. The prevalence of CSA and CSB in White-Americans were higher than in Japanese-Americans (11.5% vs 6.5% and 5.7% vs 3.3%, respectively). In multivariable-adjusted logistic regression models, CSA was associated with higher odds of AF, and the association was stronger in Japanese-Americans [Odds Ratio (OR) = 4.77, 95% confidence interval (CI): 1.95–11.67] than in White-Americans (OR = 2.09, 95 %CI: 1.09–4.01). CSB showed similar trends as CSA. Conclusions After adjustment, CSA and CSB were significantly associated with AF in both Japanese-American and White-American men.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cross-ethnic comparison of the association between central sleep apnea and atrial fibrillation/flutter: The Kuakini Honolulu-Asia Aging Study and the Osteoporotic Fractures in Men (Mr.OS) study

Anzai

Grandinetti

Katz

et al. 2021

IJC Heart & Vasculature

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Contribution of central sleep apnea to severe sleep apnea hypopnea syndrome

Zhang

Zhao

et al. 2023

Sleep Breath

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Purpose Central sleep apnea (CSA) is usually distinguished from obstructive sleep apnea (OSA). In fact, CSA is often a component of severe sleep apnea hypopnea syndrome (SAHS), rather than occurring alone. We investigated the clinical characteristics and polysomnography (PSG) parameters of CSA components in patients with severe SAHS. Methods The clinical characteristics and PSG parameters were retrospectively analyzed. Results Pure or dominant CSA was rare (5% of all patients). Of all patients with CSA, 72% also exhibited other apnea subtypes that contributed to severe SAHS. Among patients with severe SAHS, those with CSA were more likely than others to be older; thinner; exhibit higher prevalences of comorbid coronary heart disease, arrhythmia, and heart failure; a higher apnea/hypopnea index (AHI); mixed apnea index (MAI); an elevated oxygen desaturation index (ODI); and more nighttime oxygen saturation levels < 90%. Multivariate logistic regression analysis revealed that older age, comorbid arrhythmia or heart failure, and an elevated ODI were independently associated with CSA. Conclusion Patients who complain of snoring or apnea may be better evaluated by comprehensive PSG prior to treatment if they are old, show greater hypoxia, or suffer from arrhythmia and/or heart failure, because such patients are more likely than others to exhibit CSA.

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Association between sleep disorder and atrial fibrillation: A nationwide population-based cohort study

et al. 2022

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Association between central sleep apnea and atrial fibrillation/flutter in Japanese-American men: The Kuakini Honolulu Heart Program (HHP) and Honolulu-Asia Aging Study (HAAS)

Cited by 13 publications

References 33 publications

Cross-ethnic comparison of the association between central sleep apnea and atrial fibrillation/flutter: The Kuakini Honolulu-Asia Aging Study and the Osteoporotic Fractures in Men (Mr.OS) study

Cross-ethnic comparison of the association between central sleep apnea and atrial fibrillation/flutter: The Kuakini Honolulu-Asia Aging Study and the Osteoporotic Fractures in Men (Mr.OS) study

Contribution of central sleep apnea to severe sleep apnea hypopnea syndrome

Association between sleep disorder and atrial fibrillation: A nationwide population-based cohort study

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