Coexistence of obstructive sleep apnoea and metabolic syndrome is independently associated with left ventricular hypertrophy and diastolic dysfunction
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This study was conducted to investigate the impact of the severity of obstructive sleep apnoea (OSA) and metabolic syndrome (MS) on left ventricular (LV) hypertrophy and LV diastolic function.
Echocardiography for evaluation of LV hypertrophy (defined by relative wall thickness (RWT) and LV mass index (LVMI)) and for diastolic function (defined by the early rapid/atrial filling velocity (E/A ratio)) was performed on 660 OSA patients.
In patients with both MS and severe OSA, LVMI and RWT were significantly higher and the E/A ratios were significantly lower compared to patients with neither MS nor severe OSA. Multivariate analysis after adjustment for other descriptive variables demonstrated that (1) coexistent MS and severe OSA was independently associated with increased LVMI and RWT and (2) severe OSA, MS and coexistence of both disorders were independently associated with a decreased E/A ratio. Significant interaction between MS and severe OSA was not observed with respect to LVMI and RWT, but was observed for the E/A ratio.
Coexistent severe OSA and MS can exacerbate LV concentric hypertrophy. However, not only the coexistence of these two disorders, but also either severe OSA or MS can impair LV diastolic function.
KeywordsLeft ventricular diastolic function Left ventricular hypertrophy Metabolic syndrome Obstructive sleep apnoea
- 9.Usui Y, Takata Y, Inoue Y, Tomiyama H, Kurohane S, Hashimura Y, Kato K, Saruhara H, Asano K, Shiina K, Yamashina A (2011) Severe obstructive sleep apnoea impairs left ventricular diastolic function in non-obese men. Sleep Med (in press). PMID: 21377928Google Scholar
- 13.(1999) Sleep-related breathing disorders in adults: recommendations syndrome definition and measurement techniques in clinical research. The Report of an AASM Task Force. Sleep 22:667–689Google Scholar
- 14.Grungy SM, Brewer HB Jr, Cleeman JI, Smith SC Jr, Lenfant C, American Heart Association, National Heart, Lung, and Blood Institute (2004) Definition of metabolic syndrome: report of the National Heart, Lung, Blood Institute/Heart Association conference on scientific issues related to definition. Circulation 109:433–438CrossRefGoogle Scholar
- 21.Hawkins NM, Wang D, McMurray JJ, Pfeffer MA, Swedberg K, Granger CB, Yusuf S, Pocock SJ, Ostergren J, Michelson EL, Dunn F, CHARM Investigators and Committees (2007) Prevalence and prognostic implications of electrocardiographic left ventricular hypertrophy in heart failure: evidence from the CHARM programme. Heart 93:59–64PubMedCrossRefGoogle Scholar
- 26.Yusuf S, Pfeffer MA, Swedberg K, Granger CB, Held P, McMurray JJ, Michelson EL, Olofsson B, Ostergren J, CHARM Investigators and Committees (2003) Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction: the CHARM-Preserved Trial. Lancet 362:777–781PubMedCrossRefGoogle Scholar
- 27.García-Río F, Arias MA (2007) Obstructive sleep apnoea and left ventricular systolic and diastolic dysfunction. In: Javaheri S (ed) Sleep medicine clinics; sleep and cardiovascular disease. Elsevier Saunders, Philadelphia, pp 565–574Google Scholar
- 30.Shimada K, Fujita M, Tanaka A, Yoshida K, Jisso S, Tanaka H, Yoshikawa J, Kohro T, Hayashi D, Okada Y, Yamazaki T, Nagai R, JCAD investigators (2009) Elevated serum C-reactive protein levels predict cardiovascular events in the Japanese Coronary Artery Disease (JCAD) study. Circ J 73:78–85PubMedCrossRefGoogle Scholar