Literature DB >> 17908706

Decreased right and left ventricular myocardial performance in obstructive sleep apnea.

Abel Romero-Corral1, Virend K Somers, Patricia A Pellikka, Eric J Olson, Kent R Bailey, Josef Korinek, Marek Orban, Justo Sierra-Johnson, Masahiko Kato, Raouf S Amin, Francisco Lopez-Jimenez.   

Abstract

BACKGROUND: Obstructive sleep apnea (OSA) may predispose patients to congestive heart failure (CHF), suggesting a deleterious effect of OSA on myocardial contractility.
METHODS: A cross-sectional study of 85 subjects with suspected OSA who had undergone their first overnight polysomnogram, accompanied by an echocardiographic study. Patients were divided according to the apnea-hypopnea index as follows: < 5 (control subjects); 5 to 14 (mild OSA); and >or= 15 (moderate-to-severe OSA). Right and left ventricular function was evaluated using the myocardial performance index (MPI) and other echocardiographic parameters. For the right ventricle analyses, we excluded patients with a Doppler pulmonary systolic pressure of >or= 45 mm Hg, while for the left ventricle we excluded patients with an ejection fraction of <or= 45%.
RESULTS: The mean (+/- SD) age was 60 +/- 15 years, and 83% were men. Right and left ventricular function were altered in patients with OSA, especially in those with the moderate-to-severe OSA, even after adjustment for potential confounders. The mean right MPI was 0.23 +/- 0.10 in control subjects, 0.26 +/- 0.16 in patients with mild OSA, and 0.37 +/- 0.11 in patients with moderate-to-severe OSA (p value for trend, < 0.01). The mean left MPI values were 0.28 +/- 0.05, 0.27 +/- 0.07, and 0.41 +/- 0.14, respectively (p value for trend, 0.04). Right and left MPI correlated positively and significantly with the apnea-hypopnea index (rho = 0.40, p = 0.002; and rho = 0.27, p = 0.02, respectively). Mean left atrial volume index was increased in patients with OSA (control subjects, 26.8 +/- 11; patients with mild OSA, 32.5 +/- 15; and patients with moderate-to-severe OSA, 30.4 +/- 11; p value for trend, 0.04).
CONCLUSIONS: OSA, particularly when moderate to severe, is associated with impaired right and left ventricular function and increased left atrial volume. These findings support the notion that OSA may contribute to the development of atrial fibrillation and CHF.

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Year:  2007        PMID: 17908706     DOI: 10.1378/chest.07-0966

Source DB:  PubMed          Journal:  Chest        ISSN: 0012-3692            Impact factor:   9.410


  46 in total

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Authors:  Sushma M Dharia; Lee K Brown
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7.  Continuous positive airway pressure therapy reduces right ventricular volume in patients with obstructive sleep apnea: a cardiovascular magnetic resonance study.

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