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Relationship between diastolic ventricular dysfunction and subclinical sleep-disordered breathing in atrial fibrillation ablation candidates

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Abstract

Sleep-disordered breathing (SDB) is recognized as a primary factor or mediator of atrial fibrillation (AF). We hypothesized that the severity of SDB among AF ablation candidates would be associated with left ventricular diastolic dysfunction (LVDD) even for subclinical SDB. A total of 246 patients hospitalized for initial pulmonary vein isolation (PVI) were analyzed. Known SDB cases were excluded. We measured the oxygen desaturation index (ODI) by pulse oximetry overnight as an indicator of SDB, and classified SDB severity by 3 % ODI as normal (ODI < 5 events/h), mild (ODI ≤ 5 to <15 events/h), or moderate-to-severe (ODI ≥15 events/h). The LVDD was assessed by echocardiography using combined categories with tissue Doppler imaging and left atrial (LA) volume measurement. Among the participants, 42 patients (17.1 %) had LVDD. The prevalence of LVDD increased with the SDB severity from 8.6 % (normal) to 12.7 % (mild) to 40.0 % (moderate-to-severe SDB) (p < 0.0001). In the multivariate logistic regression analysis, the odds ratio of having LVDD in the moderate-to-severe SDB group (ODI ≥ 15) vs. normal group (ODI < 5) was 5.96 (95 % CI, 2.10–19.00, P = 0.006). The presence of moderate-to-severe SDB in AF ablation candidates adversely affected LV diastolic function even during a subclinical state of SDB.

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Acknowledgments

We would like to thank Mr. John Martin for the linguistic assistance in the preparation of this manuscript.

Conflict of interest

The authors declare that there is no conflict of interest. This research received no grant from any funding agencies in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Department Cardiology, Tenri Hospital, Tenri, Nara, Japan

    Kazuaki Kaitani, Hirokazu Kondo, Naoaki Onishi, Yukiko Hayama, Akira Tsujimura, Maiko Kuroda, Shunsuke Nishimura, Yusuke Yoshikawa, Yusuke Takahashi, Masashi Amano, Sari Imamura, Yodo Tamaki, Soichiro Enomoto, Makoto Miyake, Toshihiro Tamura, Chisato Izumi & Yoshihisa Nakagawa

  2. Division of Cardiology, Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan

    Koji Hanazawa

  3. Division of Cardiology, Shizuoka General Hospital, Shizuoka, Japan

    Makoto Motooka

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  1. Kazuaki Kaitani
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Correspondence to Kazuaki Kaitani.

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Kaitani, K., Kondo, H., Hanazawa, K. et al. Relationship between diastolic ventricular dysfunction and subclinical sleep-disordered breathing in atrial fibrillation ablation candidates. Heart Vessels 31, 1140–1147 (2016). https://doi.org/10.1007/s00380-015-0705-x

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