Document Detail


Severe obstructive sleep apnea elicits concentric left ventricular geometry.
MedLine Citation:
PMID:  20411620     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Obstructive sleep apnea (OSA) has several negative effects on the heart including increase in myocardial end-systolic stress, venous return and sympathetic activity, all potential stimuli of left ventricular (LV) hypertrophy. The impact of the severity of OSA on LV geometry is unknown. We hypothesized that OSA is related to concentric LV geometry. METHODS: One hundred and fifty-seven patients with suspected OSA underwent echocardiography, ambulatory 24-h blood pressure and ECG monitoring. On the basis of the severity of OSA, patients were divided into controls, mild OSA and moderate/severe OSA (apnea-hypopnea index <5, 5-15 and >15/h, respectively). Patients with LV hypertrophy were defined as LV mass at least 49.2 g/m2.7 for men and at least 46.7 for women. Relative wall thickness of at least 0.43 identified patients with concentric LV geometry. RESULTS: Patients with moderate/severe OSA (n = 86) had a higher body mass index and a higher prevalence of paroxysmal atrial fibrillation than those (n = 51) with mild OSA and controls (n = 20). Prevalence of hypertension, diabetes, obesity, LV mass and blood pressure did not differ between the groups. Relative wall thickness was positively related to apnea-hypopnea index (r = 0.30; P = 0.003) and the prevalence of concentric LV geometry was 20% in controls, 12% in mild OSA and 58% in moderate/severe OSA (P < 0.001). In logistic regression analysis concentric LV geometry was associated with moderate/severe OSA [odds ratio (OR) 7.6, P < 0.001], low stress-corrected midwall shortening (OR 3.38, P = 0.004), and higher body mass index (OR 1.09, P = 0.03). CONCLUSIONS: Moderate/severe OSA is associated with high prevalence of concentric LV geometry. This increased prevalence may in part explain the increased rate of cardiovascular events in these patients.
Authors:
Giovanni Cioffi; Tiziano Edoardo Russo; Carlo Stefenelli; Alessandro Selmi; Francesco Furlanello; Dana Cramariuc; Eva Gerdts; Giovanni de Simone
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of hypertension     Volume:  28     ISSN:  1473-5598     ISO Abbreviation:  J. Hypertens.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-21     Completed Date:  2010-07-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  1074-82     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Villa Bianca Hospital, Trento, Italy. gcioffi@villabiancatrento.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Atrial Fibrillation / etiology
Body Mass Index
Cardiovascular Diseases / etiology
Case-Control Studies
Female
Humans
Hypertension / complications
Hypertrophy, Left Ventricular / etiology*,  pathology*,  physiopathology
Male
Middle Aged
Obesity / complications
Risk Factors
Sleep Apnea, Obstructive / complications*,  pathology*,  physiopathology
Ventricular Dysfunction, Left / etiology,  pathology,  physiopathology

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