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Aortic elastic properties and left ventricular diastolic dysfunction in patients with obstructive sleep apnea

Heart and Vessels volume 20, pages 239–244 (2005)Cite this article

Abstract

Although the responsible mechanisms are not yet fully known, obstructive sleep apnea is associated with an increased risk for cardiovascular disease and events. The aorta is not only a conduit delivering blood to the tissues but is also an important modulator of the entire cardiovascular system, its elastic properties also affecting left ventricular function and coronary blood flow. The aim of this study was to determine left ventricular diastolic function and aortic elastic properties in patients with obstructive sleep apnea syndrome. Fourteen male patients with obstructive sleep apnea and 14 age- and body mass index-matched healthy male controls took part in the study as a control group. All subjects underwent echocardiographic examination; left ventricular cavity dimension, standard and tissue Doppler parameters, and aortic diameter (3 cm above aortic valve) at systole and diastole were measured. While the aortic stiffness index in patients with obstructive sleep apnea was significantly higher than that of the control group (4.5 ± 0.3 vs 2.1 ± 0.1, P = 0.001), the aortic distensibility index was found to be lower in this group compared with controls (2.4 ± 1.2 vs 3.9 ± 1.5 cm2 dynes−1 10−6, P = 0.009). Furthermore, peak velocity of myocardial systolic wave and peak velocities of myocardial diastolic waves in sleep apnea patients were lower than in controls. There was an association between aortic stiffness and the apnea hypopnea index (coefficient = 0.49, P = 0.002). We also found an inverse correlation between peak velocity of myocardial diastolic wave and aortic stiffness (coefficient = −0.43, P = 0.003), using multiple linear regression. Increased aortic stiffness that is associated with the severity of disease in patients with obstructive sleep apnea may lead to diastolic dysfunction of the left ventricle.

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References

  1. M Koskenvuo J Kaprio M Partinen H Langinvanio S Sarna K Heikkila (1985) ArticleTitleSnoring as a risk factor for hypertension and angina pectoris Lancet 1 89–95

    Google Scholar 

  2. S Malone PP Liu R Holloway R Rutherford A Xie TD Bradley (1991) ArticleTitleObstructive sleep apnoea in patients with dilated cardiomyopathy: effects of continuous positive airway pressure Lancet 338 1480–1484 Occurrence Handle1683918 Occurrence Handle1:STN:280:DyaK38%2FnvFGrtg%3D%3D

    PubMed  CAS  Google Scholar 

  3. M Partinen C Guilleminault (1990) ArticleTitleDaytime sleepiness and vascular morbidity at seven-year follow-up in obstructive sleep apnea patients Chest 97 27–32 Occurrence Handle2295260 Occurrence Handle1:STN:280:DyaK3c7gslGksA%3D%3D

    PubMed  CAS  Google Scholar 

  4. K Narkiewicz N Montano C Cogliati PJ van de Borne ME Dyken VK Somers (1998) ArticleTitleAltered cardiovascular variability in obstructive sleep apnea Circulation 98 1071–1077 Occurrence Handle9736593 Occurrence Handle1:STN:280:DyaK1cvgvFGiuw%3D%3D

    PubMed  CAS  Google Scholar 

  5. J Hedner H Ejnell J Sellgren T Hedner Wallin (1988) ArticleTitleIs high and fluctuating muscle nerve sympathetic activity in the sleep apnoea syndrome of pathogenetic importance for the development of hypertension? J Hypertens 6 IssueIDSuppl S529–S531 Occurrence Handle1:STN:280:DyaL1M7pvFaqsg%3D%3D

    CAS  Google Scholar 

  6. H Kraiczi K Caidahl A Samuelsson Y Peker J Hedner (2001) ArticleTitleImpairment of vascular endothelial function and left ventricular filling: association with the severity of apnea-induced hypoxemia during sleep Chest 119 1085–1091 Occurrence Handle11296174 Occurrence Handle1:STN:280:DC%2BD3M3jslKktw%3D%3D Occurrence Handle10.1378/chest.119.4.1085

    PubMed  CAS  Article  Google Scholar 

  7. ED Shifflett EW Walker JM Gregg D Zedalis WG Herbet (2001) ArticleTitleEffects of short-term PAP treatment on exercise performance in obstructive sleep apnea patients Sleep Med 2 145–151

    Google Scholar 

  8. C Stefanadis C Stratos H Boudoulas C Kourouklis P Toutouzas (1990) ArticleTitleDistensibility of the ascending aorta: comparison of invasive and noninvasive techniques in healthy men and in men with coronary artery disease Eur Heart J 11 990–996 Occurrence Handle2282929 Occurrence Handle1:STN:280:DyaK3M7jtVGhsQ%3D%3D

    PubMed  CAS  Google Scholar 

  9. C Stefanadis C Stratos C Vlachopoulos S Marakas H Boudoulas I Kallikazaros E Tsiamis K Toutouzas L Sioros P Toutouzas (1995) ArticleTitlePressure-diameter relation of the human aorta: a new method of determination by the application of a special ultrasonic dimension catheter Circulation 92 2210–2219 Occurrence Handle7554204 Occurrence Handle1:STN:280:DyaK28%2Fhslejsg%3D%3D

    PubMed  CAS  Google Scholar 

  10. E Kasikcioglu H Oflaz H Akhan A Kayserilioglu F Mercanoglu B Umman Z Bugra (2004) ArticleTitleLeft ventricular remodeling and aortic distensibility in elite power athletes Heart Vessels 19 183–188 Occurrence Handle15278392

    PubMed  Google Scholar 

  11. E Kasikcioglu A Kayserilioglu H Oflaz H Akhan (2005) ArticleTitleAortic distensibility and left ventricular diastolic functions in endurance athletes Int J Sport Med 26 165–170 Occurrence Handle1:STN:280:DC%2BD2M7ksVKiug%3D%3D

    CAS  Google Scholar 

  12. InstitutionalAuthorNameAmerican Sleep Disorders Association (1997) ArticleTitlePractice parameters for the indications for polysomnography and related procedures. Polysomnography task force, American Sleep Disorders Association Standards of Practice Committee Sleep 20 406–422

    Google Scholar 

  13. C Cuhadaroglu N Keles B Erdamar N Aydemir E Yucel F Oguz K Deger (2003) ArticleTitleBody position and obstructive sleep apnea syndrome Pediatr Pulmonol 36 335–338 Occurrence Handle12950048 Occurrence Handle10.1002/ppul.10366

    PubMed  Article  Google Scholar 

  14. RB Devereux N Reichek (1977) ArticleTitleEchocardiographic determination of left ventricular mass: anatomic validation of the method Circulation 55 613–618 Occurrence Handle138494 Occurrence Handle1:STN:280:DyaE2s7hsVClsQ%3D%3D

    PubMed  CAS  Google Scholar 

  15. PS Douglas N Reichek T Plappert A Muhammad MG Sutton (1987) ArticleTitleComparison of echocardiographic methods for assessment of left ventricular shortening and wall stress J Am Coll Cardiol 9 945–951 Occurrence Handle3558991 Occurrence Handle1:STN:280:DyaL2s7mslWluw%3D%3D Occurrence Handle10.1016/S0735-1097(87)80253-X

    PubMed  CAS  Article  Google Scholar 

  16. JM Bland DG Altman (1986) ArticleTitleStatistical methods for assessing agreement between two methods of clinical measurement Lancet 1 307–310 Occurrence Handle2868172 Occurrence Handle1:STN:280:DyaL287hslWqsQ%3D%3D

    PubMed  CAS  Google Scholar 

  17. KL Kwok DK Ng YF Cheung (2003) ArticleTitleBP and arterial distensibility in children with primary snoring Chest 123 1561–1566 Occurrence Handle12740274 Occurrence Handle10.1378/chest.123.5.1561

    PubMed  Article  Google Scholar 

  18. T Young L Finn KM Hla B Morgan M Palta (1996) ArticleTitleSnoring as a part of a dose-response relationship between sleep-disordered breathing and blood pressure Sleep 19 S202–S205 Occurrence Handle9085511 Occurrence Handle1:STN:280:DyaK2s3jvFymsg%3D%3D

    PubMed  CAS  Google Scholar 

  19. MF O'Rourke G Mancia (1999) ArticleTitleArterial stiffness J Hypertens 17 1–4 Occurrence Handle10100086

    PubMed  Google Scholar 

  20. SH Launois N Averill JH Abraham DA Kirby JW Weiss (2001) ArticleTitleCardiovascular responses to nonrespiratory and respiratory arousals in a porcine model J Appl Physiol 90 114–120 Occurrence Handle11133900 Occurrence Handle1:STN:280:DC%2BD3M7ns1Kjuw%3D%3D

    PubMed  CAS  Google Scholar 

  21. L Chen Q Shi SM Scharf (2000) ArticleTitleHemodynamic effects of periodic obstructive apneas in sedated pigs with congestive heart failure J Appl Physiol 88 1051–1060 Occurrence Handle10710403 Occurrence Handle1:STN:280:DC%2BD3c7nsFGltA%3D%3D

    PubMed  CAS  Google Scholar 

  22. J Hedner (2000) ArticleTitleRegulation of systemic vasculature in obstructive sleep apnea syndrome Sleep 23 IssueIDSuppl S132–S135 Occurrence Handle10893086

    PubMed  Google Scholar 

  23. M Kato P Roberts-Thomson BG Phillips WG Haynes M Winnicki V Accurso VK Somers (2000) ArticleTitleImpairment of endothelium-dependent vasodilation of resistance vessels in patients with obstructive sleep apnea Circulation 102 2607–2610 Occurrence Handle11085964 Occurrence Handle1:STN:280:DC%2BD3M%2FkvFWnug%3D%3D

    PubMed  CAS  Google Scholar 

  24. S Kourembanas PA Marsden LP McQuillan DV Faller (1991) ArticleTitleHypoxia induces endothelin gene expression and secretion in cultured human endothelium J Clin Invest 88 1054–1057 Occurrence Handle1885767 Occurrence Handle1:CAS:528:DyaK3MXlsFKhtb4%3D Occurrence Handle10.1172/JCI115367

    PubMed  CAS  Article  Google Scholar 

  25. H Kraiczi J Hedner Y Peker J Carlson (2000) ArticleTitleIncreased vasoconstrictor sensitivity in obstructive sleep apnea J Appl Physiol 89 493–498 Occurrence Handle10926630 Occurrence Handle1:CAS:528:DC%2BD3cXmtleltrs%3D

    PubMed  CAS  Google Scholar 

  26. K Kario J Ishikawa K Eguchi M Morinari S Hoshide S Ishikawa K Shimada (2004) ArticleTitleSleep pulse pressure and awake mean pressure as independent predictors for stroke in older hypertensive patients Am J Hypertens 17 439–445 Occurrence Handle15110904

    PubMed  Google Scholar 

  27. VA Imadojemu K Gleeson KS Gray LI Sinoway UA Leuenberger (2002) ArticleTitleObstructive apnea during sleep is associated with peripheral vasoconstriction Am J Respir Crit Care Med 165 61–66 Occurrence Handle11779731

    PubMed  Google Scholar 

  28. EC Fletcher G Bao R Li (1999) ArticleTitleRenin activity and blood pressure in response to chronic episodic hypoxia Hypertension 34 309–314 Occurrence Handle10454459 Occurrence Handle1:CAS:528:DyaK1MXlvFGmtbc%3D

    PubMed  CAS  Google Scholar 

  29. AS Shamsuzzaman BJ Gersh VK Somers (2003) ArticleTitleObstructive sleep apnea: implications for cardiac and vascular disease JAMA 290 1906–1914 Occurrence Handle14532320 Occurrence Handle1:CAS:528:DC%2BD3sXotVWktbo%3D Occurrence Handle10.1001/jama.290.14.1906

    PubMed  CAS  Article  Google Scholar 

  30. RS Amin TR Kimball M Kalra JL Jeffries JL Carroll JA Bean SA Witt BJ Glascock SR Daniels (2005) ArticleTitleLeft ventricular function in children with sleep-disordered breathing Am J Cardiol 95 801–804 Occurrence Handle15757619 Occurrence Handle10.1016/j.amjcard.2004.11.044

    PubMed  Article  Google Scholar 

  31. N Ohte H Narita M Sugawara K Niki T Okada A Harada J Hayano G Kimura (2003) ArticleTitleClinical usefulness of carotid arterial wave intensity in assessing left ventricular systolic and early diastolic performance Heart Vessels 18 93–99

    Google Scholar 

  32. RA Dart JR Gregoire DD Gutterman SH Woolf (2003) ArticleTitleThe association of hypertension and secondary cardiovascular disease with sleep-disordered breathing Chest 123 244–260 Occurrence Handle12527627

    PubMed  Google Scholar 

  33. JM Parish JW Shepard (1990) ArticleTitleCardiovascular effects of sleep disorders Chest 97 1220–1226 Occurrence Handle2184999 Occurrence Handle1:STN:280:DyaK3c3jsFKmsg%3D%3D

    PubMed  CAS  Google Scholar 

  34. P Hanly Z Sasson N Zuberi K Lunn (1993) ArticleTitleST-segment depression during sleep in obstructive sleep apnea Am J Cardiol 71 1341–1345 Occurrence Handle8498378 Occurrence Handle1:STN:280:DyaK3s3mvFylsA%3D%3D Occurrence Handle10.1016/0002-9149(93)90552-N

    PubMed  CAS  Article  Google Scholar 

  35. J Chan J Sanderson W Chan C Lai D Choy A Ho R Leung (1997) ArticleTitlePrevalence of sleep-disordered breathing in diastolic heart failure Chest 111 1488–1493 Occurrence Handle9187161 Occurrence Handle1:STN:280:DyaK2szjtVOjsA%3D%3D

    PubMed  CAS  Google Scholar 

  36. E Eisenberg R Zimlichman P Lavie (1990) ArticleTitlePlasma norepinephrine levels in patients with sleep apnea syndrome N Engl J Med 322 932–933 Occurrence Handle2314430 Occurrence Handle1:STN:280:DyaK3c7ptVOkug%3D%3D

    PubMed  CAS  Google Scholar 

  37. R Stoohs C Guilleminault (1992) ArticleTitleCardiovascular changes associated with the obstructive sleep apnea syndrome J Appl Physiol 75 583–589

    Google Scholar 

  38. A Buda J Schroeder C Guilleminault (1981) ArticleTitleAbnormalities of pulmonary artery wedge pressure in sleep apnea Int J Cardiol 1 67–74 Occurrence Handle7333716 Occurrence Handle1:STN:280:DyaL387ktFaiuw%3D%3D Occurrence Handle10.1016/0167-5273(81)90050-4

    PubMed  CAS  Article  Google Scholar 

  39. CW Zwillich (1999) ArticleTitleObstructive sleep apnoea causes transient and sustained systemic hypertension Int J Clin Pract 53 301–305 Occurrence Handle10563076 Occurrence Handle1:STN:280:DC%2BD3c%2FivVyitA%3D%3D

    PubMed  CAS  Google Scholar 

  40. SF Quan DegreesMD BJ Gersh (2004) ArticleTitleCardiovascular consequences of sleep-disordered breathing: past, present and future Circulation 109 951–957 Occurrence Handle14993147 Occurrence Handle10.1161/01.CIR.0000118216.84358.22

    PubMed  Article  Google Scholar 

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Affiliations

  1. Siyami Ersek Cardiovascular Surgery Center, Resitpasa caddesi Salkim sokak No. 2/5, Avcilar (PK 9), 34840, Istanbul, Turkey

    Hulya Akhan Kasikcioglu

  2. Yedikule Chest Disease and Surgery Center, Istanbul, Turkey

    Levent Karasulu

  3. Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey

    Ebru Durgun, Huseyin Oflaz, Erdem Kasikcioglu & Caglar Cuhadaroglu

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  1. Hulya Akhan Kasikcioglu
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  2. Levent Karasulu
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  5. Erdem Kasikcioglu
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  6. Caglar Cuhadaroglu
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Correspondence to Hulya Akhan Kasikcioglu.

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Kasikcioglu, H., Karasulu, L., Durgun, E. et al. Aortic elastic properties and left ventricular diastolic dysfunction in patients with obstructive sleep apnea. Heart Vessels 20, 239–244 (2005). https://doi.org/10.1007/s00380-005-0839-3

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  • DOI: https://doi.org/10.1007/s00380-005-0839-3

Key words

  • Stiffness
  • Diastolic function
  • Echocardiography