Atrial Fibrosis Progression in Sleep Apnea Patients: A Pilot Study
Atrial Fibrosis Progression in Sleep Apnea Patients: A Pilot Study
The investigators hypothesize that Obstructive Sleep Apnea (OSA) is an independent risk
 factor for atrial fibrosis development. The investigators aim to prove the presence and
 progression of atrial fibrosis on Delayed Enhancement Magnetic Resonance Imaging (DE-MRI) in
 OSA patients without atrial fibrillation (AF).

 The investigators will also investigate the correlation between OSA metrics (nocturnal oxygen
 saturation and Apnea Hypopnea Index (AHI)) and degree of fibrosis at baseline and its
 progression.
This is a prospective observational pilot study. Fifteen mild to severe OSA patients and five
 age- and Body Mass Index (BMI)-matched controls will undergo a DE-MRI. Demographics, medical
 history and polysomnography results will be collected. Patients diagnosed with obstructive
 sleep apnea have undergone a polysomnography before the study and were diagnosed based on
 this test. The investigators will not be performing a polysomnography for any of the
 patients, just collecting the previous results from their medical charts to confirm they have
 a true OSA diagnosis for their inclusion in the study.

 Patients will be followed over a period of 6 months with a wearable device (WATCHPAT 300)
 that will record a home sleep apnea study biweekly, including OSA metrics like AHI and
 nocturnal oxygen variations. Patients will also use an ElectroCardioGram (ECG) Check device
 for arrhythmia detection.
Inclusion Criteria:

 -  Experimental group: (15 patients)

 -  18-75-year-old, AND

 -  With mild to severe OSA (mild: Apnea Hypopnea Index: AHI between 5-15, Moderate
 AHI= 15-30, severe AHI>30), diagnosed by polysomnography.

 -  Patient with a creatinine measurement within the last 6 months.

 -  Control group (5 patients): patients with no lung or heart disease, matched by age and
 BMI.

 Exclusion Criteria:

 -  History of chronic heart failure (Left Ventricle Ejection fraction (LVEF) < 50%), AF,
 myocardial infarction, valvular disease.

 -  Prior cardiac or chest surgery.

 -  Other advanced pulmonary disease (severe Chronic Obstructive Pulmonary Disease (COPD)
 or asthma, pulmonary hypertension) or central sleep apnea.

 -  Contraindications to DE-MRI (e.g. allergy to gadolinium, pacemakers, defibrillators
 (ICD's), other devices/implants contraindicated for MRI, glomerular filtration rate
 <30 ml/min, etc.).

 -  BMI > 35 kg/m2 (affects DE-MRI quality).

 -  Pregnancy.

 -  Contraindications to WATCHPAT device (peripheral neuropathy).

 -  Use of one of the following medications: alpha blockers, short acting nitrates (less
 than 3 hours before the use of WATCHPAT).

 -  Inability to give informed consent.

 -  No access to proper smartphone technology and/or internet.

 -  Inability to return to follow up visit.