| Obstructive sleep apnea syndrome: more insights on structural and functional cardiac alterations, and the effects of treatment with continuous positive airway pressure. | |
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MedLine Citation:
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PMID: 16580533 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: We studied structural and functional cardiac alterations in obstructive sleep apnea (OSA), their relationship to the severity of OSA, and the effects of treatment with continuous positive airway pressure (CPAP). BACKGROUND: Obstructive sleep apnea may influence the cardiac function by several mechanisms in the awake patient. METHODS: Left and right ventricular morphology and function were studied using echocardiography before and after treatment with CPAP in symptomatic patients (Epworth sleepiness score, 10 +/- 4.8) with severe OSA (apnea-hypopnea index [AHI], 42 +/- 24). The patients (n = 43, 32 men) had no known cardiac disease and were obese (body mass index, 31.6 +/- 5.4 kg/m2). The same echocardiographic parameters were studied in age-matched overweight patients (n = 40; body mass index, 26.4 +/- 2.3 kg/m2). RESULTS: The patients were hypertensive (systolic blood pressure, 153 +/- 25 mm Hg), with a higher resting heart rate (77 +/- 10 beats/min, p = 0.008) compared with age-matched control patients (n = 40). There was right ventricular dilatation, hypertrophic interventricular septum, reduced left ventricular stroke volume, tissue Doppler-determined systolic and diastolic velocities of the left and right ventricle, and normal pulmonary artery pressure. The structural and functional parameters were significantly associated with AHI (p < 0.004). Multiple stepwise regression showed the interventricular septum thickness, right ventricular free wall, and mitral annulus tissue Doppler systolic velocities to be predictive of a higher AHI (p < 0.001). Six months after treatment with CPAP, significant improvements were observed in the symptoms and hemodynamics, as well as left and right ventricular morphology and function. CONCLUSIONS: The structural and functional consequences of OSA on the heart are influenced by the severity of AHI. These effects are reversible if the apneic episodes are abolished. |
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Authors:
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Bharati Shivalkar; Caroline Van de Heyning; Mieke Kerremans; Diana Rinkevich; Johan Verbraecken; Wilfried De Backer; Christiaan Vrints |
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Publication Detail:
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Type: Journal Article Date: 2006-03-15 |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 47 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2006 Apr |
Date Detail:
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Created Date: 2006-04-03 Completed Date: 2006-05-26 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1433-9 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiology and Pulmonary Medicine, University Hospital Antwerp, Antwerp, Belgium. bharati.shivalkar@skynet.be |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Case-Control Studies Continuous Positive Airway Pressure* Echocardiography* Female Heart / physiopathology* Hemodynamics Humans Male Middle Aged Severity of Illness Index Sleep Apnea, Obstructive / physiopathology*, therapy, ultrasonography* Treatment Outcome |
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