Clinical Characteristics of Hypertensive Patients with Obstructive Sleep Apnoea Syndrome Developing Different Types of Left Ventricular Geometry

Abstract

Objective. The objective of the study was to compare polygraphic parameters and selected laboratory parameters in patients with obstructive sleep apnoea (OSA) who develop various types of left ventricular (LV) geometry. Material and Methods. The research covered 122 patients with obstructive sleep apnoea and coexisting effectively treated systemic hypertension (95 men, 27 women, average age: 54 ± 10.63 ). Overnight polygraphy, echocardiography, carotid artery ultrasonography, and laboratory measurements were performed. The patients were classified into four groups, depending on LV geometry. Group 1 comprised patients with normal LV geometry, group 2 included those with LV concentric remodelling. Group 3 and group 4 were patients with LV hypertrophy, concentric or eccentric, respectively. Results. The most frequent type of LV geometry in the examined population was eccentric hypertrophy (36%). The highest average values of BMI and T-Ch were observed in the group of patients with concentric remodelling (group 2). The most severe respiratory disorders were found in the group of patients developing LV concentric hypertrophy (group 3); however, these differences were not statistically significant in comparison to other groups. Patients with LV eccentric hypertrophy had significantly decreased LV ejection fraction ( p = 0.0008 ). Conclusions. LV eccentric hypertrophy is the most frequent type of LV geometry in OSA patients. Patients with severe sleep-disordered breathing are more likely to develop concentric hypertrophy, while concentric remodelling occurs more frequently among OSA patients with other coexisting conditions, such as obesity or lipid-related disorders.

Left Ventricular Systolic Dysfunction in Patients of Obstructive Sleep Apnea Syndrome

“…Myslinski et al 16 studied a similar phenomenon from another angle and compared polygraphic parameters and selected laboratory parameters in patients with obstructive sleep apnea (OSA) who develop various types of left ventricular (LV) geometry. Their findings were that left ventricular eccentric hypertrophy was the commonest type of left ventricular geometry in patients with obstructive sleep apnea syndrome.…”

Association of the TNF‐α‐308G>A gene polymorphism with left ventricular geometry and functional abnormalities in obstructive sleep apnea subjects

“…17 Our research indicated that the morbidity of abnormal LVG among OSA subjects was 52.9%, including 26.3%, 10.8%, and 15.8% in the CR, EH and CH groups, respectively. Myslinski et al 18 reported that the morbidity rates of the CR, EH, and CH groups in OSA patients were 20%, 36%, and 20%, respectively. There may be several reasons for this discrepancy.…”

Obstructive sleep apnea and right ventricular function: A meta‐analysis of speckle tracking echocardiographic studies

“…A large amount of evidence supports the view that OSA is associated with an increased risk of non‐fatal and fatal cardiovascular (CV) events as well as all‐cause mortality 5,6 . One of the mechanisms underlying the poor CV prognosis in patients with OSA is the development of structural and functional cardiac changes triggered by the hemodynamic, hormonal and inflammatory consequences of nocturnal arterial desaturation 7,8 …”

“… 5 , 6 One of the mechanisms underlying the poor CV prognosis in patients with OSA is the development of structural and functional cardiac changes triggered by the hemodynamic, hormonal and inflammatory consequences of nocturnal arterial desaturation. 7 , 8 …”

“…5,6 One of the mechanisms underlying the poor CV prognosis in patients with OSA is the development of structural and functional cardiac changes triggered by the hemodynamic, hormonal and inflammatory consequences of nocturnal arterial desaturation. 7,8 Over the past few decades, hundreds of studies and their metaanalyses, have examined the effects of OSA on subclinical cardiac damage targeting left ventricular hypertrophy (LVH) and LV dysfunction. 9,10 A recent meta-analysis of 39 studies including 5550 patients with OSA and 2329 non-OSA controls from 39 studies suggested that the risk of LVH in patients with OSA was 70% higher than in non-OSA counterparts and linked to the OSA severity.…”