Yung-Lung Chen1, Mao-Chang Su2, Wen-Hao Liu1, Chin-Chou Wang2, Meng-Chih Lin2, Mien-Cheng Chen1. 1. Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan. 2. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Abstract
STUDY OBJECTIVE: Obstructive sleep apnea syndrome (OSAS) has been considered to be an important predisposing factor for cardiovascular disease. This study aims to investigate the impact of OSAS on cardiac function and remodeling in patients without congestive heart failure. METHODS: A total of 79 patients with sleep disordered breathing, preserved systolic function, and normal pro-brain natriuretic peptide level were enrolled. Sixty-five patients were classified to have moderate to severe OSAS (apnea-hypopnea index [AHI] ≥ 15/h), while the other 14 patients with mild or no OSAS (AHI < 15/h) served as control subjects. Baseline clinical and polysomnographic variables as well as tissue Doppler imaging and three-dimensional echocardiographic parameters were obtained. RESULTS: The body mass index, neck circumference, Epworth Sleepiness Scale, desaturation index, arousal index, and snoring index were significantly higher in patients with moderate to severe OSAS than those without (p < 0.05). The left atrial size, mitral A-wave velocity, and left ventricular end-diastolic volume were significantly larger, while E/A ratio was lower in patients with moderate to severe OSAS than those without (p < 0.05). Notably, AHI in REM sleep was significantly correlated with the aortic root size, E/A ratio, left ventricular volume, and stroke volume. In addition, the area under the receiver operator characteristic curve for AHI in REM sleep ≥ 32.3/h was 0.647 (95% CI [0.525, 0.769]) in predicting the development of left ventricular diastolic dysfunction. AHI in REM sleep ≥ 32.3/h was the only independent variant in predicting diastolic dysfunction after adjusting the variables including age, gender, hypertension, and body mass index. CONCLUSIONS: Patients with moderate to severe OSAS tend to have cardiac dysfunction revealed by echocardiography. High AHI in REM sleep is significantly associated with cardiovascular remodeling and ventricular diastolic dysfunction, and may be a potential variable to predict cardiac dysfunction.
STUDY OBJECTIVE:Obstructive sleep apnea syndrome (OSAS) has been considered to be an important predisposing factor for cardiovascular disease. This study aims to investigate the impact of OSAS on cardiac function and remodeling in patients without congestive heart failure. METHODS: A total of 79 patients with sleep disordered breathing, preserved systolic function, and normal pro-brain natriuretic peptide level were enrolled. Sixty-five patients were classified to have moderate to severe OSAS (apnea-hypopnea index [AHI] ≥ 15/h), while the other 14 patients with mild or no OSAS (AHI < 15/h) served as control subjects. Baseline clinical and polysomnographic variables as well as tissue Doppler imaging and three-dimensional echocardiographic parameters were obtained. RESULTS: The body mass index, neck circumference, Epworth Sleepiness Scale, desaturation index, arousal index, and snoring index were significantly higher in patients with moderate to severe OSAS than those without (p < 0.05). The left atrial size, mitral A-wave velocity, and left ventricular end-diastolic volume were significantly larger, while E/A ratio was lower in patients with moderate to severe OSAS than those without (p < 0.05). Notably, AHI in REM sleep was significantly correlated with the aortic root size, E/A ratio, left ventricular volume, and stroke volume. In addition, the area under the receiver operator characteristic curve for AHI in REM sleep ≥ 32.3/h was 0.647 (95% CI [0.525, 0.769]) in predicting the development of left ventricular diastolic dysfunction. AHI in REM sleep ≥ 32.3/h was the only independent variant in predicting diastolic dysfunction after adjusting the variables including age, gender, hypertension, and body mass index. CONCLUSIONS:Patients with moderate to severe OSAS tend to have cardiac dysfunction revealed by echocardiography. High AHI in REM sleep is significantly associated with cardiovascular remodeling and ventricular diastolic dysfunction, and may be a potential variable to predict cardiac dysfunction.
Authors: Virend K Somers; David P White; Raouf Amin; William T Abraham; Fernando Costa; Antonio Culebras; Stephen Daniels; John S Floras; Carl E Hunt; Lyle J Olson; Thomas G Pickering; Richard Russell; Mary Woo; Terry Young Journal: Circulation Date: 2008-08-25 Impact factor: 29.690
Authors: Miguel A Arias; Francisco García-Río; Alberto Alonso-Fernández; Olga Mediano; Isabel Martínez; José Villamor Journal: Circulation Date: 2005-07-11 Impact factor: 29.690
Authors: H Klar Yaggi; John Concato; Walter N Kernan; Judith H Lichtman; Lawrence M Brass; Vahid Mohsenin Journal: N Engl J Med Date: 2005-11-10 Impact factor: 91.245
Authors: Kamran Mahmood; Natasha Akhter; Kamal Eldeirawi; Ergün Onal; John W Christman; David W Carley; James J Herdegen Journal: J Clin Sleep Med Date: 2009-06-15 Impact factor: 4.062
Authors: W Oliveira; O Campos; F Cintra; L Matos; M L C Vieira; B Rollim; L Fujita; S Tufik; D Poyares Journal: Heart Date: 2009-07-29 Impact factor: 5.994
Authors: Rupa Lakshmi Iyengar-Kapuganti; Cynara S Maceda; Lori B Croft; Simonette T Sawit; Laura E Crowley; Mark Woodward; Mary Ann McLaughlin Journal: BMJ Open Date: 2022-04-19 Impact factor: 3.006
Authors: Lindsay D'Silva; Maria Wilczynska; Keir Lewis; Matthew Lawrence; Karl Hawkins; Rhodri Williams; Sophia Stanford; Simon Davidson; Keith Morris; Adrian Evans Journal: Sleep Sci Date: 2016-02-23
Authors: Sergio Garbarino; Paola Lanteri; Paolo Durando; Nicola Magnavita; Walter G Sannita Journal: Int J Environ Res Public Health Date: 2016-08-18 Impact factor: 3.390
Authors: Rebecca Robbins; Amanda Sonnega; Robert W Turner; Girardin Jean-Louis; Mark Butler; Ricardo S Osorio; Kenneth M Langa Journal: Innov Aging Date: 2020-06-29