Left ventricular hypertrophy independent of hypertension in patients with obstructive sleep apnoea

Hedner, Jan; Ejnell, Hasse; Caidahl, Kenneth

doi:10.1097/00004872-199010000-00009

Cited by 228 publications

(128 citation statements)

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“…Septal hypertrophy was observed more often in apnoeic than in nonapnoeic patients, although the two groups did not differ with regard to the prevalence of systemic arterial hypertension, and the severity of obesity. These results are in accordance with those of HEDNER et al [20] who showed that, in obese patients with normal blood pressure, the left ventricular mass is larger in apnoeic patients than in weight-paired nonapnoeic patients. Obstructive apnoeas may lead to left ventricular hypertrophy via several mechanisms: an increase in left ventricular afterload during apnoeas that results from systemic vasoconstriction and high intrathoracic negative pressures, and a permanent rise in sympathetic activity [5].…”

Section: Discussionsupporting

confidence: 93%

Cardiorespiratory consequences of sleep apnoea syndrome in patients with massive obesity

Laaban¹,

Cassuto²,

Orvoen-Frija³

et al. 1998

Eur Respir J

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aaSleep apnoea syndrome (SAS) has been reported to be associated with excess mortality [1,2] and a wide range of cardiac and respiratory sequelae [3][4][5]: daytime alveolar hypoventilation, pulmonary arterial hypertension, systemic arterial hypertension, left ventricular hypertrophy and dysfunction, cardiac arrhythmias and ischaemic heart disease. However, conflicting data have been published on the cardiorespiratory consequences of SAS. This might be due to the fact that most studies did not take sufficient account of the potential effects of confounding variables, such as age, smoking, and obesity [6]. Obesity is a major confounding factor as it is strongly associated with SAS [7,8], and may yield the same cardiorespiratory complications as SAS. Therefore, observing cardiac and respiratory abnormalities in an obese patient with SAS does not necessarily imply a causal association between nocturnal apnoeas and cardiorespiratory morbidity.Another confounding factor is the association of chronic obstructive pulmonary disease (COPD), which may explain certain conflicting results on the role of SAS in the development of daytime alveolar hypoventilation and pulmonary arterial hypertension [9][10][11].The aim of the present study was to assess the cardiorespiratory consequences of SAS by comparing the results of a comprehensive cardiorespiratory evaluation in apnoeic and nonapnoeic patients with a similar degree of obesity, i.e. massive obesity and without COPD. This study investigated the role of SAS in the development of daytime alveolar hypoventilation, pulmonary arterial hypertension, systemic arterial hypertension, left ventricular dysfunction, left ventricular hypertrophy and dilatation, cardiac arrhythmias and coronary artery disease. Patients and methods Study populationThe study population included morbidly obese patients admitted consecutively over a 3 yr period to the Nutrition department of Hôtel-Dieu Hospital for an extensive Nocturnal apnoeas in massive obesity may thus be associated with moderate daytime hypoxaemia, mild pulmonary arterial hypertension and moderate left ventricular hypertrophy, but not with severe cardiorespiratory complications.

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Section: Discussionsupporting

confidence: 93%

Cardiorespiratory consequences of sleep apnoea syndrome in patients with massive obesity

Laaban¹,

Cassuto²,

Orvoen-Frija³

et al. 1998

Eur Respir J

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“…However, other studies have stated that the rate of mortality is significantly higher in non-treated patients with AHI values over 20 [14], and the incidence of CVD in non-treated patients with moderate-severe OSAS is markedly increased compared to normal individuals or treated patients [15]. This supports the point of view that OSAS is an important risk factor, particularly in case of hypertension and CVD [15][16][17][18]. Left ventricular diastolic dysfunction is a common finding in patients with hypertensive OSAS patients.…”

Section: Discussionmentioning

confidence: 53%

Early left ventricular functional alterations in patients with obstructive sleep apnea syndrome

Aslan

Deniz²,

Çaylı³

et al. 2013

Cardiol J

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“…A multivariate analysis should have been used in a large study population, to explain the effects of blood pressures or hypoxemia on LVH. Hedner et al 16 reported that OSAS causes LVH in a study that compared 61 males with OSAS with 61 male control subjects. The OSAS group was heavier and 50% had systemic hypertension.…”

Section: Discussionmentioning

confidence: 99%

The incremental effect of obstructive sleep apnea syndrome on right and left ventricular myocardial performance in newly diagnosed essential hypertensive subjects

Gao

Hua

et al. 2009

Hypertens Res

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Obstructive sleep apnea syndrome (OSAS) may predispose patients to congestive heart failure, suggesting a deleterious effect of OSAS on myocardial contractility. We investigated whether essential hypertensive individuals with OSAS are characterized by decreased right and left ventricular myocardial performance. Our study population consisted of 45 consecutive patients with newly diagnosed untreated stage I-II essential hypertension suffering from OSAS (35 men, aged 49 ± 8 years) and 48 hypertensives without OSAS, matched for age, sex, level of blood pressure, heart rate, body mass index and smoking status. All subjects underwent polysomnography and echocardiography. Right and left ventricular functions were evaluated using the myocardial performance index (MPI). Right and left ventricular functions were altered in hypertensives with OSAS. The mean right MPI was 0.26 ± 0.11 in hypertensives without OSAS and 0.51 ± 0.16 in hypertensives with OSAS (Po0.01). The mean left MPI values were 0.29 ± 0.07 and 0.44 ± 0.13, respectively (Po0.01). Right and left MPI correlated positively and significantly with apnea-hypopnea index (q¼0.40, P¼0.002).OSAS is associated with impaired right and left ventricular function. These phenomena were independent of hypertension.

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Left ventricular hypertrophy independent of hypertension in patients with obstructive sleep apnoea

Cited by 228 publications

References 0 publications

Cardiorespiratory consequences of sleep apnoea syndrome in patients with massive obesity

Cardiorespiratory consequences of sleep apnoea syndrome in patients with massive obesity

Early left ventricular functional alterations in patients with obstructive sleep apnea syndrome

The incremental effect of obstructive sleep apnea syndrome on right and left ventricular myocardial performance in newly diagnosed essential hypertensive subjects

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