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Effect of acute sleep deprivation on left atrial mechanics assessed by three-dimensional echocardiography

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Abstract

Background

Although sleep deprivation (SD) affects cardiovascular system in many ways, physio-pathological changes in cardiac chamber volume and function have not been described well. The aim of the present study was to investigate the effect of SD on left atrial (LA) and ventricular function with three-dimensional (3D) echocardiography.

Methods

Thirty-two healthy individuals (12 females, mean age 33.25 ± 8.18) were evaluated. Echocardiographic examination was performed once after a night of regular sleep and a night of sleep debt. Beside conventional parameters, 3D phasic volumes and function were measured using a commercially available 3D echocardiography system and offline analysis software.

Results

Mean sleep duration of the study group was 8.15 ± 2.19 h in the day of regular sleep and 2.56 ± 2.25 h in the day of sleep deprivation. There was a significant prolongation in deceleration time (180.83 ± 15.34 vs. 166.44 ± 26.12; p = 0.044) and increase in E/e’ (6.95 ± 1.26 vs. 6.38 ± 0.85; p = 0.005). Among 3D measurements, the difference in left ventricular ejection fraction (EF), LA EF, LA reservoir function and LA active EF were not significant. Mean LA passive EF of the individuals was significantly lower after night shift (24.10 ± 7.66 vs. 31.49 ± 7.75; p = 0.006).

Conclusion

Acute SD is associated with a reduction in LA passive emptying function in healthy adults. 3D-derived indices were sufficient to show subclinical diastolic dysfunction according to impairment in passive phase of LA ejection. Prospective large-scale studies are needed to enlighten this issue.

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Conflict of interest

The authors certify that there is no conflict of interest with any financial organization regarding the material discussed in this article.

Author contributions

Concept/design: Ibrahim Sari M.D. Data analysis/interpretation: Altug Cincin M.D., Murat Sunbul M.D. Drafting article: Altug Cincin M.D. and Ibrahim Sari M.D. Critical revision of article: Yelda Basaran M.D., Kursat Tigen M.D. Approval of article: Altug Cincin M.D. Statistics: Alper Kepez M.D., Beste Ozben M.D. Data collection: Mustafa Oguz M.D., Sena Sert M.D., Anıl Sahin M.D.

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Authors and Affiliations

  1. Department of Cardiology, Marmara University Faculty of Medicine, Pendik, Istanbul, Turkey

    Altug Cincin, Ibrahim Sari, Murat Sunbul, Alper Kepez, Mustafa Oguz, Sena Sert, Anil Sahin, Beste Ozben, Kursat Tigen & Yelda Basaran

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  1. Altug Cincin
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  2. Ibrahim Sari
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  3. Murat Sunbul
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  7. Anil Sahin
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  8. Beste Ozben
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Correspondence to Altug Cincin.

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Comments

In the present paper Dr. Cincin and colleagues present an interesting study on the impact of acute sleep deprivation on left atrial function. The study fits into a number of investigations showing that not only sleep apnea but also “simple” sleep deprivation can have adverse effects on cardiac function. The authors studied 32 healthy volunteers after a night of regular sleep and after a night with sleep deprivation. (Partial) sleep deprivation was induced by work during the night (8.2 versus 2.6 hours of sleep). Participants underwent comprehensive echocardiography to assess systolic and diastolic left ventricular function and left atrial function. The authors were able to show an increase in the mitral inflow deceleration time and a reduction of the early diastolic mitral annular velocity, i.e., worsening of two important measures of left ventricular diastolic function, and a reduction in left atrial passive emptying function with left atrial volumes derived from 3D echocardiography, i.e., an impairment in passive left atrial function, while active left atrial function, i.e., left atrial contraction was unaffected. A previous study with a similar design hat revealed that sleep deprivation resulted in a reduced left atrial early strain rate, another measure of left atrial function. Thus, the present study provides additional evidence that sleep deprivation at least if acute can lead to subtle changes in left ventricular diastolic function and thereby passive left atrial function. Further studies will be required to elucidate the long-term consequences of these findings, and the impact of these data obtained in healthy volunteers for patients with pre-existing cardiac disease.

Micha T. Maeder

St. Gallen, Switzerland

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Cincin, A., Sari, I., Sunbul, M. et al. Effect of acute sleep deprivation on left atrial mechanics assessed by three-dimensional echocardiography. Sleep Breath 20, 227–235 (2016). https://doi.org/10.1007/s11325-015-1211-1

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