Key result
Severe obstructive sleep apnea (AHI 42 ± 24) was associated with cardiac alterations (p<0.004), which significantly improved after 6 months of continuous positive airway pressure treatment.
Why the study?
Obstructive sleep apnea may influence cardiac function through several mechanisms in awake patients, but structural and functional cardiac alterations and the effects of continuous positive airway pressure required further study.
Does continuous positive airway pressure (CPAP) improve left and right ventricular morphology and function in patients with severe obstructive sleep apnea?
Observational (n=83)
Does continuous positive airway pressure (CPAP) improve left and right ventricular morphology and function in patients with severe obstructive sleep apnea?
Severe obstructive sleep apnea is associated with reversible structural and functional cardiac alterations that improve after 6 months of CPAP therapy.
OBJECTIVES: We studied structural and functional cardiac alterations in obstructive sleep apnea (OSA), their relationship to the severity of OSA, and the effects of treatment with continuous positive airway pressure (CPAP). BACKGROUND: Obstructive sleep apnea may influence the cardiac function by several mechanisms in the awake patient. METHODS: Left and right ventricular morphology and function were studied using echocardiography before and after treatment with CPAP in symptomatic patients (Epworth sleepiness score, 10 +/- 4.8) with severe OSA (apnea-hypopnea index [AHI], 42 +/- 24). The patients (n = 43, 32 men) had no known cardiac disease and were obese (body mass index, 31.6 +/- 5.4 kg/m2). The same echocardiographic parameters were studied in age-matched overweight patients (n = 40; body mass index, 26.4 +/- 2.3 kg/m2). RESULTS: The patients were hypertensive (systolic blood pressure, 153 +/- 25 mm Hg), with a higher resting heart rate (77 +/- 10 beats/min, p = 0.008) compared with age-matched control patients (n = 40). There was right ventricular dilatation, hypertrophic interventricular septum, reduced left ventricular stroke volume, tissue Doppler-determined systolic and diastolic velocities of the left and right ventricle, and normal pulmonary artery pressure. The structural and functional parameters were significantly associated with AHI (p < 0.004). Multiple stepwise regression showed the interventricular septum thickness, right ventricular free wall, and mitral annulus tissue Doppler systolic velocities to be predictive of a higher AHI (p < 0.001). Six months after treatment with CPAP, significant improvements were observed in the symptoms and hemodynamics, as well as left and right ventricular morphology and function. CONCLUSIONS: The structural and functional consequences of OSA on the heart are influenced by the severity of AHI. These effects are reversible if the apneic episodes are abolished.
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Shivalkar et al. (2006) conducted an observational in Obstructive sleep apnea (n=83). Continuous positive airway pressure (CPAP) vs. Age-matched overweight controls and baseline measurements was evaluated on Left and right ventricular morphology and function. Severe obstructive sleep apnea (AHI 42 ± 24) was associated with cardiac alterations (p<0.004), which significantly improved after 6 months of continuous positive airway pressure treatment.
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