Decreased Right and Left Ventricular Myocardial Performance in Obstructive Sleep Apnea

Romero‐Corral, Abel; Somers, Virend K.; Pellikka, Patricia A.; Olson, Eric J.; Bailey, Kent R.; Kořínek, Josef; Orban, Marek; Sierra‐Johnson, Justo; Kato, Masahiko; Amin, Raouf S.; López-Jiménez, Francisco

doi:10.1378/chest.07-0966

Cited by 139 publications

(102 citation statements)

References 32 publications

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“…This negative intrathoracic pressure increases transmural gradients across the atria, ventricles, and aorta 118,119 and disrupts ventricular function 118 and autonomic and hemodynamic stability. 120 Consequences may include increased wall stress, increased afterload, increased atrial size, 121,122 impaired diastolic function, 121,123 thoracic aortic dilation, and propensity toward dissection. 124 Whether repetitive nocturnal increases in transmural gradients may contribute in the longer term to ventricular hypertrophy and remodeling and associated clinical consequences remains to be established.…”

Section: Intrathoracic Pressure Changesmentioning

confidence: 99%

Sleep Apnea and Cardiovascular Disease

et al. 2008

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Section: Intrathoracic Pressure Changesmentioning

confidence: 99%

Sleep Apnea and Cardiovascular Disease

et al. 2008

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“…19 In a previous report, a correlation between AHI and biventricular TD-MPI was identified, similar to our findings. 20 Obstructive sleep apnea (AHI >5) was inversely correlated with RV function when compared to that in control subjects. 21,22 Therefore, in the current study, our main purpose was to show the relationship between biventricular TD-MPI and OSA severity as indicated by increases in AHI, rather than by the presence of OSA.…”

Section: Discussionmentioning

confidence: 97%

Biventricular Myocardial Performance Is Impaired in Proportion to Severity of Obstructive Sleep Apnea

Akyol¹,

Çörtük²,

Baykan³

et al. 2016

Texas Heart Institute Journal

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“…It has been hypothesized that the increased transmural gradients across the atria, ventricles and aorta, which may disrupt ventricular function and result from changes in intrathoracic pressure during obstructive events, lead to autonomic and hemodynamic instability (32). OSA has been associated with impaired right and left ventricular function in adults (34), and similarly, children with OSA have been identified with left ventricular hypertrophy and cardiac remodeling (6,7). Studies have not been conducted to determine the effect of repetitive changes in intrathoracic pressure when there are a large number of respiratory events that are occurring close together, on autonomic and hemodynamic instability.…”

Section: Repetitive Respiratory Events In Childrenmentioning

confidence: 99%

Augmented cardiovascular responses to episodes of repetitive compared with isolated respiratory events in preschool children with sleep-disordered breathing

et al. 2015

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Data presented as mean ± SEM or median (range). *P < 0.05; † P < 0.001. HR, heart rate; PTT, pulse transit time. Articles Walter et al. Cardiovascular Consequences of Repetitive vs. Isolated Respiratory EventsFor the episodes of repetitive events, the % change in HR from late to between events and from late event to postepisode were significantly higher when compared with the % change in HR from late to postevent in isolated respiratory events (P < 0.001 for both), as shown in Figure 2a. The % change in PTT from late event to postepisode was significantly greater (indicating a greater change in BP) for repetitive episodes when compared with the % change from late to postevents in isolated respiratory events (P < 0.05) (Figure 2b). There was no difference between % change in PTT from late to between events in repetitive episodes compared with % change from late to postevents in isolated respiratory events. The ratio of repetitive to isolated respiratory events for each child significantly predicted the mean HR, which increased with an increasing proportion of repetitive respiratory events compared with isolated events during N1, N2, REM, and total sleep (Figure 3). There were no relationships between mean PTT and the ratio of repetitive to isolated respiratory events during wake or any sleep stage. Determinants of Percentage Change in HR and PTT From Lateto Between-Event Phases in Episodes of Repetitive Respiratory EventsResults of the multiple linear regression analysis indicate that during total sleep, the repetitive to isolated events ratio, the number of individual respiratory events per episode, the number of arousals per episode, the ratio of the duration of the respiratory event to the duration of the subsequent between event period, and sleep stage were significantly, if weakly predictive of the % change in HR from the late event phase to between the respiratory events ( Table 3). The model predicted 44% of the % change in HR from the late event phase to between the respiratory events (P < 0.01). This suggests that the more repetitive events compared with isolated events, the more episodes, the more events and arousals per episode a child has, the higher the surge in HR. In contrast, there is a negative relationship between the surge in HR and sleep stage, suggesting that the HR surge is highest during N1 and decreases during N2, N3, and REM. There is also a weak negative relationship between the surge in HR and the ratio of the duration of an event to the duration of the between event period, suggesting that the closer together the events become the % change in HR is not as great.Further analyses separating the repetitive respiratory event episodes into the sleep stage in which they occurred demonstrated that when the episodes occurred during N1 sleep, the predictive variables remained the same as for total sleep. When the episodes occurred during N2 or REM sleep, only the number of arousals in the episode predicted the change in HR (r 2 = 0.3, P < 0.01; REM: r 2 = 0.5, P < 0.001). None of the variables ...

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Decreased Right and Left Ventricular Myocardial Performance in Obstructive Sleep Apnea

Cited by 139 publications

References 32 publications

Sleep Apnea and Cardiovascular Disease

Sleep Apnea and Cardiovascular Disease

Biventricular Myocardial Performance Is Impaired in Proportion to Severity of Obstructive Sleep Apnea

Augmented cardiovascular responses to episodes of repetitive compared with isolated respiratory events in preschool children with sleep-disordered breathing

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