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The Editors are Retracting the Following Paper and Abstract:
Fogel RB, Malhotra A, Dalagiorgou G, Robinson MK, Jakab M, Kikinis R, Pittman SD, White DP. Anatomic and physiologic predictors of apnea severity in morbidly obese subjects. Sleep 2003; 26(2):150-155.
Fogel RB, Malhotra A, Pillar G, Dalagiorgou G, Pittman S, Jalab M, Robinson, M, White DP. The effect of surgically induced weight loss on sleep disordered breathing and pharyngeal anatomy. Sleep (Abstract Supplement) 2001;24: A7.
The Dean for Faculty and Research Integrity at Harvard Medical School notified the Editor of SLEEP on February 10, 2009, that they completed a review of both publications and reached the conclusion that Robert B. Fogel, M.D., former Harvard Medical School Assistant Professor of Medicine at the Brigham and Women’s Hospital, falsified and fabricated data that were reported in the paper and the abstract. All other authors on the paper and on the abstract were found to be innocent of misconduct. Having been retracted based on falsified data, the paper and abstract should not be cited.
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Study Objectives:While obesity is the most common risk factor for the development of obstructive sleep apnea, the correlation between measures of obesity and apnea severity is only moderate. We thus attempted to identify anatomic and physiologic predictors of apnea severity.
Design: We combined a careful assessment of upper airway anatomy, upper airway physiology, and ventilatory control in a group of obese individuals to identify predictors of apnea severity.
Setting:Tertiary care academic medical center.
Patients:14 morbidly obese subjects being evaluated for weight-reduction surgery.
Interventions:N/A
Measurement and Results:We found no relationship between obesity (weight or body mass index) and apnea severity (respiratory disturbance index, RDI). However, those with severe apnea (RDI > 30) were found to have higher peak genioglossus EMG (GGEMG) (23.5 +/- 1.9 vs. 14.1 +/-3.7 %max, p = 0.05) and greater airway collapsibility during pulses of negative pressure (7.6 +/- 0.9 vs. 4.4 +/-0.7 cmH2O, p =0.02). Airway collapsibility was significantly associated with RDI (r = 0.62, p < 0.01) as was peak GGEMG (r = 0.55, p < 0.05). Of the anatomic variables airway shape (A-P/lateral ratio) and volume change of the pharyngeal airway between total lung capacity and residual volume were different between those with and without severe apnea. Both correlated with RDI (A-P/lateral ratio: r= 0.70, p < 0.01 and volume change: r = 0.77, p < 0.01).
Conclusions:We believe these findings suggest that specific anatomic and physiologic properties of the airway interact with obesity to predispose to the development of airway collapse during sleep.
Citation: Fogel RB, Malhotra A, Dalagiorgou G, Robinson MK, Jakab M, Kikinis R, Pittman SD. White DP. Anatomic and physiologic predictors of apnea severity in morbidly obese subjectsSLEEP2002;26:150-55