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Research ArticleORIGINAL RESEARCH

Risk of Left Atrial Enlargement in Obese Patients With Obesity-Induced Hypoventilation Syndrome vs Obstructive Sleep Apnea

Yasser Al-Khadra, Fahed Darmoch, Mohammad Alkhatib, Motaz Baibars and M. Chadi Alraies
Ochsner Journal June 2018, 18 (2) 136-140; DOI: https://doi.org/10.31486/toj.17.0091
Yasser Al-Khadra
1Department of Internal Medicine, Cleveland Clinic, Cleveland, OH
MD
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Fahed Darmoch
1Department of Internal Medicine, Cleveland Clinic, Cleveland, OH
MD
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Mohammad Alkhatib
2Department of Internal Medicine, St. Vincent Charity Medical Center, Cleveland, OH
MD
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Motaz Baibars
3Department of Hospital Medicine, Johns Hopkins Medicine, Howard County General Hospital, Columbia, MD
MD
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M. Chadi Alraies
4Department of Interventional Cardiology, Wayne State University, Detroit Medical Center, Detroit, MI
MD
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  • For correspondence: alraies{at}hotmail.com
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    Figure. Forest plot of adjusted odds ratios (OR) for the predictors of left atrial diameter. AF, atrial fibrillation; CAD, coronary artery disease; CHF, congestive heart failure; LCL, lower control limit; LVEF, left ventricular ejection fraction; OHS, obesity-induced hypoventilation syndrome; OSA, obstructive sleep apnea; T2DM, type 2 diabetes mellitus; UCL, upper control level.

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    Table 1. Demographic and Baseline Characteristics of Patients With Obesity-Induced Hypoventilation Syndrome (OHA) and Obstructive Sleep Apnea (OSA) vs Patients With OSA Alone
    VariableOHS+OSA
    n = 104
    OSA Alone
    n = 106
    P Value
    Sex0.568
     Male44 (42)49 (46)
     Female60 (58)57 (54)
    Age, years, mean ± SD60.25 ± 12.5559.36 ± 11.870.598
    Body mass index, kg/m2, median47.0043.500.008
    African American66 (64)69 (65)0.576
    Continuous positive airway pressure compliance84 (81)85 (80)0.915
    Type 2 diabetes mellitus82 (79)67 (63)0.013
    Left atrium diameter, cm, median4.454.200.014
    LVEF, %, median55550.116
    LVEF <50%23 (22)22 (21)0.777
    Coronary artery disease38 (37)58 (55)0.008
    Atrial fibrillation23 (22)24 (23)1.000
    Congestive heart failure77 (74)60 (57)0.008
    Stroke3 (3)13 (12)0.010
    • Note: Data are reported as n (%) unless otherwise indicated.

    • LVEF, left ventricular ejection fraction.

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    Table 2. Univariate and Multivariate Logistic Regression Analyses for the Predictors of Left Atrial Diameter ≥4
    PredictorUnivariate Odds Ratio (95% CI)P ValueMultivariate Odds Ratio (95% CI)P Value
    Group (OHS+OSA vs OSA alone)1.947 (1.040 to 3.647)0.0372.151 (1.016 to 4.550)0.045
    Sex (male vs female)2.235 (1.165 to 4.288)0.0162.267 (1.112 to 4.619)0.024
    Age ≥75 years1.721 (0.556 to 5.324)0.3461.218 (0.350 to 4.233)0.757
    Body mass index1.004 (0.978 to 1.031)0.7711.013 (0.981 to 1.046)0.440
    Type 2 diabetes mellitus0.895 (0.443 to 1.704)0.6630.583 (0.266 to 1.274)0.176
    Coronary artery disease1.293 (0.696 to 2.402)0.4161.743 (0.833 to 3.647)0.140
    Congestive heart failure1.607 (0.857 to 3.013)0.1391.368 (0.660 to 2.838)0.400
    Atrial fibrillation3.825 (1.429 to 10.238)0.0083.236 (1.143 to 9.163)0.027
    Left ventricular ejection fraction <50%1.419 (0.648 to 3.106)0.3811.112 (0.469 to 2.635)0.809
    • CI, confidence interval; OHS, obesity-induced hypoventilation syndrome; OSA, obstructive sleep apnea.

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Ochsner Journal: 18 (2)
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Risk of Left Atrial Enlargement in Obese Patients With Obesity-Induced Hypoventilation Syndrome vs Obstructive Sleep Apnea
Yasser Al-Khadra, Fahed Darmoch, Mohammad Alkhatib, Motaz Baibars, M. Chadi Alraies
Ochsner Journal Jun 2018, 18 (2) 136-140; DOI: 10.31486/toj.17.0091

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Risk of Left Atrial Enlargement in Obese Patients With Obesity-Induced Hypoventilation Syndrome vs Obstructive Sleep Apnea
Yasser Al-Khadra, Fahed Darmoch, Mohammad Alkhatib, Motaz Baibars, M. Chadi Alraies
Ochsner Journal Jun 2018, 18 (2) 136-140; DOI: 10.31486/toj.17.0091
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