Severe Obstructive Sleep Apnea Is Associated With Left Ventricular Diastolic Dysfunction

Fung, Jeffrey Wing‐Hong; Li, Thomas S.T.; Choy, D.; Yip, Gabriel W.K.; Ko, Fanny W.S.; Sanderson, John E.; Hui, David S.

doi:10.1378/chest.121.2.422

Cited by 254 publications

(192 citation statements)

References 53 publications

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“…Our finding of an association of OSA with diastolic dysfunction is supported by other studies [18,[20][21][22]30], although these studies are limited by a small sample size of between 20 and 68 participants. In a cohort of .500 patients, NIROUMAND et al [23] did not show an association of OSA with diastolic function.…”

Section: Osa and Diastolic Dysfunctionsupporting

confidence: 89%

“…However, it is currently unclear whether OSA is an independent risk factor for diastolic dysfunction and diastolic heart failure. Smaller studies in OSA patients revealed that oxygen desaturation [20,21] or obstructive apnoeas [22] were associated with abnormalities of diastolic filling. However, such an association could not be confirmed in a large cross-sectional study including .500 patients with OSA [23].…”

mentioning

confidence: 99%

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Impact of obstructive sleep apnoea on diastolic function

et al. 2012

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We investigated whether obstructive sleep apnoea (OSA) independently affects diastolic function in a primary care cohort of patients with cardiovascular risk factors.378 study participants with risk factors for diastolic dysfunction were prospectively included and a polygraphy was performed in all patients. Diastolic dysfunction was assessed by comprehensive echocardiography including tissue Doppler. Sleep apnoea was classified according to apnoea/ hypopnoea index (AHI) as none (AHI ,5 events?h ). Patients with central sleep apnoea (n514) and patients with previously diagnosed sleep apnoea (n512) were excluded. In the remaining 352 subjects, 21.6% had an AHI o15 events?h -1 . The prevalence of diastolic dysfunction increased with the severity of sleep apnoea from 44.8% (none) to 56.8% (mild) to 69.7% (moderate-to-severe sleep apnoea) (p50.002). The degree of diastolic dysfunction also increased with sleep apnoea severity (p50.004). In univariate regression analysis, age, desaturation index, AHI, cardiac frequency, angiotensin receptor 1 antagonist therapy, body mass index (BMI) and left ventricular mass were associated with diastolic dysfunction. In multivariate regression analysis, only age, BMI, AHI and cardiac frequency were independently associated with diastolic dysfunction.Moderate-to-severe OSA is independently associated with diastolic dysfunction in patients with classical risk factors for diastolic dysfunction.

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Section: Osa and Diastolic Dysfunctionsupporting

confidence: 89%

mentioning

confidence: 99%

Impact of obstructive sleep apnoea on diastolic function

et al. 2012

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“…173 Nocturnal oxygen desaturation is an independent predictor of impaired ventricular relaxation during diastole. 174 In the Framingham study, increased BMI, an important predisposing factor for OSA, also was associated with greater risk of developing heart failure. 175 It has been suggested that left ventricular hypertrophy is more closely linked to hypertension during sleep than during wakefulness.…”

Section: Osa and The Origin And Progression Of Heart Failurementioning

confidence: 98%

Sleep Apnea and Cardiovascular Disease

et al. 2008

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“…In addition to increasing arterial stiffness, obesity is associated with 4‐fold greater prevalence of OSA, which contributes to the pathogenesis of HFpEF through multiple mechanisms: Sympathetic activation increases LV afterload, hypoxic pulmonary vasoconstriction reduces LV preload, oxidative stress stimulates inflammation, and hypoxia predisposes to atrial and ventricular arrhythmias 125, 126, 127, 128, 129…”

Section: Obesity Phenotypementioning

confidence: 99%

“…Independently from hypertension and obesity, OSA impairs LV diastolic function, begets LVH, and thus may hasten HFpEF progression 126, 127, 252, 253, 254, 255, 256, 257, 258. Repetitive sleep arousals and hypoxic episodes heighten sympathetic activity and promote endothelial dysfunction, systemic inflammation, and arterial stiffness that may further increase blood pressure and accelerate atherosclerosis progression 128, 259, 260, 261, 262, 263, 264, 265…”

Section: Comorbid Conditionsmentioning

confidence: 99%