Key result
Severe obstructive sleep apnea was associated with significantly higher myocardial performance index compared to mild disease (0.8 vs 0.5, P<0.01) and increased left ventricular mass.
Why the study?
Obstructive sleep apnea causes increased cardiovascular morbidity and mortality, but the relationship between OSA severity and left ventricular mass and myocardial performance index is not well characterized.
Does the severity of obstructive sleep apnea correlate with increased left ventricular mass and worsened myocardial performance index in patients without known cardiopulmonary disease?
Cross-Sectional (n=40)
No
Does the severity of obstructive sleep apnea correlate with increased left ventricular mass and worsened myocardial performance index in patients without known cardiopulmonary disease?
Increasing severity of obstructive sleep apnea is associated with greater left ventricular mass and worse myocardial performance index, suggesting progressive subclinical cardiac dysfunction.
BACKGROUND AND OBJECTIVES: Obstructive sleep apnea (OSA) causes increased cardiovascular morbidity and mortality, including systemic arterial hypertension, coronary heart disease, heart rhythm and conduction disorders, heart failure and stroke. In our study, we aimed to assess left ventricular mass and myocardial performance index (MPI) in OSA patients. DESIGN AND SETTING: A cross-sectional study conducted between May 2007 and August 2009 in a tertiary hospital in Istanbul, Turkey. PATIENTS AND METHODS: Forty subjects without any cardiac or pulmonary disease referred for evaluation of OSA had overnight polysomnography and echocardiography. According to the apnea-hypopnea index (AHI), subjects were classified into three groups; mild OSA (AHI: 5-14/h; n=7), moderate OSA (AHI: 15-29/h; n=13), and severe OSA (AHI: ;ge;30/h; n=20). The thickness of the interventricular septum (IVS) and left ventricular posterior wall (LVPW) were measured by M-mode along with left ventricular mass (LVM) and LVM index (LVMI). The left ventricular MPI was calculated as (isovolumic contraction time + isovolumic relaxation time)/aortic ejection time by Doppler echocardiography. RESULTS: No differences were observed in age or body mass index among the groups, but blood pressures were higher in severe OSA compared with moderate and mild OSA. In severe OSA, the thickness of the IVS (11.6 [1.7 mm]), LVPW (10.7 [1.7 mm]), LVM (260.9 [50.5 g]), and LVMI (121.9 [21.1g/m2]) were higher than in moderate OSA (9.4 [1.3 mm]; 9.9 [1.6]; 196.4 [35.2]; 94.7 [13.2 g/m2], respectively) and mild OSA (9.8 [2.4 mm], 8.9 [2.0 mm], 187.6 [66.2 g], 95.8 [28.6 g/m2], respectively). In severe OSA, MPI (0.8 [0.2]) was significantly higher than in mild OSA (0.5 [P<.01]) but not significantly higher than moderate OSA (0.8 [0.1]). CONCLUSIONS: OSA patients have demonstrable cardiac abnormalities that worsen with the severity of apnea. The MPI may have utility in subsequent OSA studies, possibly as a surrogate outcome measure.
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Altıntaş et al. (2012) conducted a cross-sectional in Obstructive sleep apnea (OSA) (n=40). Severe obstructive sleep apnea vs. Mild and moderate obstructive sleep apnea was evaluated on Left ventricular mass and myocardial performance index (MPI) (p=<.01). Severe obstructive sleep apnea was associated with significantly higher myocardial performance index compared to mild disease (0.8 vs 0.5, P<0.01) and increased left ventricular mass.
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