Left Ventricular Hypertrophy Is a Common Echocardiographic Abnormality in Severe Obstructive Sleep Apnea and Reverses With Nasal Continuous Positive Airway Pressure*

Cloward, Tom V.; Walker, James M.; Farney, Robert J.; Anderson, Jeffrey L.

doi:10.1378/chest.124.2.594

Cited by 150 publications

(127 citation statements)

References 46 publications

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“…9,10 Indeed, OSA is an established risk factor for the development of hypertension independent of obesity and is associated with difficulty to control blood pressure 11 and left ventricular hypertrophy. 12 Therapies that immediately prevent airway obstruction such as nasal continuous positive airway pressure (CPAP), mandibular advancement splints (MAS) and upper airway surgery currently form the primary treatment modality for OSA with clinical advice about the more long-term benefits of weight loss having a secondary role. The efficacy of CPAP treatment in OSA is well established, but adherence is generally suboptimal.…”

Section: Introductionmentioning

confidence: 99%

The effect of sibutramine-assisted weight loss in men with obstructive sleep apnoea

et al. 2006

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Objective: Obstructive sleep apnoea (OSA) occurs frequently in obese patients and may be reversible with weight loss. Obstructive sleep apnoea and obesity are both independent risk factors for hypertension and increased sympathetic activity. Sibutramine has been increasingly used in the management of obesity, but is relatively contraindicated in patients with hypertension. No studies have investigated the effect of sibutramine on OSA, blood pressure and heart rate. We aimed to assess the changes in OSA and cardiovascular parameters in obese men with OSA enrolled in a sibutramine-assisted weight loss programme (SIB-WL). Design: Open uncontrolled cohort study of obese male subjects with OSA in an SIB-WL. Subjects: Eighty-seven obese (body mass index ¼ 34.272.8 kg/m 2 ) middle-aged (46.379.3 years) male subjects with symptomatic OSA (Epworth score 13.473.6; respiratory disturbance index (RDI) 46.0723.1 events/h) completed the study. Results: At 6 months, there was significant weight loss (8.374.7 kg, Po0.0001), as well as a reduction in waist and neck circumference and sagittal height (all Po0.0001). These changes were accompanied by a reduction in OSA severity (RDI fell by 16.3719.4 events/h and Epworth score by 4.574.6), both Po0.0001). There was no significant change to systolic (P ¼ 0.07) or diastolic blood pressure (P ¼ 0.87); however, there was a mild rise in resting heart rate (Po0.0001). Conclusion: Moderate (B10%) weight loss with SIB-WL results in improvement in OSA severity without increase in blood pressure in closely monitored OSA subjects.

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Section: Introductionmentioning

confidence: 99%

The effect of sibutramine-assisted weight loss in men with obstructive sleep apnoea

et al. 2006

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“…A clinic-based study of 533 subjects found that those with obstructive SDB had greater height-adjusted LVM than those without, but this difference was not significant after adjustment for age, obesity, and hypertension. 12 Several other case-control studies or case series found an association of obstructive SDB with LVH, [13][14][15][16][17] although others did not. 18 -20 Continuous positive airway pressure therapy for 6 months resulted in significant regression of LVH as measured by interventricular septal thickness but not LV posterior wall thickness in 1 study, 13 whereas decreased interventricular septal thickness was observed along with improved LV function in another study.…”

Section: Clinical Perspective P 2607mentioning

confidence: 99%

“…12 Several other case-control studies or case series found an association of obstructive SDB with LVH, [13][14][15][16][17] although others did not. 18 -20 Continuous positive airway pressure therapy for 6 months resulted in significant regression of LVH as measured by interventricular septal thickness but not LV posterior wall thickness in 1 study, 13 whereas decreased interventricular septal thickness was observed along with improved LV function in another study. 17 In the present study, we test the primary hypothesis that SDB is associated with increased LVM index as measured by echocardiography in the large, community-based sample of adults participating in the Sleep Heart Health Study (SHHS).…”

Section: Clinical Perspective P 2607mentioning

confidence: 99%

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Sleep-Disordered Breathing

Lavie¹,

Vishnevsky²,

Lavie³

et al. 2013

Encyclopedia of Behavioral Medicine

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Background-Whether sleep-disordered breathing (SDB) is a risk factor for left ventricular (LV) hypertrophy and dysfunction is controversial. We assessed the relation of SDB to LV morphology and systolic function in a community-based sample of middle-aged and older adults. Methods and Results-The present study was a cross-sectional observational study of 2058 Sleep Heart Health Study participants (mean age 65Ϯ12 years; 58% women; 44% ethnic minorities) who had technically adequate echocardiograms. A polysomnographically derived apnea-hypopnea index (AHI) and hypoxemia index (percent of sleep time with oxyhemoglobin saturation Ͻ90%) were used to quantify SDB severity. LV mass index was significantly associated with both AHI and hypoxemia index after adjustment for age, sex, ethnicity, study site, body mass index, current and prior smoking, alcohol consumption, systolic blood pressure, antihypertensive medication use, diabetes mellitus, and prevalent myocardial infarction. Adjusted LV mass index was 41.3 (SD 9.90) g/m 2.7 in participants with AHI Ͻ5 (nϭ957) and 44.1 (SD 9.90) g/m 2.7 in participants with AHI Ն30 (nϭ84) events per hour. Compared with participants with AHI Ͻ5, those with AHI Ն30 had an adjusted odds ratio of 1.78 (95% confidence interval 1.14 to 2.79) for LV hypertrophy. A higher AHI and higher hypoxemia index were also associated with larger LV diastolic dimension and lower LV ejection fraction, with a trend toward lower LV fractional shortening. LV wall thickness was significantly associated with the hypoxemia index but not with AHI. Left atrial diameter was not associated with either SDB measure. Conclusions-In

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“…Pathophysiologisch erscheint der Zusammenhang jedoch glaubhaft. Auch weisen zahlreiche experimentelle Studien darauf hin, dass ein OSAS einen Risikofaktor für die Entstehung der Arteriosklerose sein könnte und eine CPAP-Therapie dieses Risiko zu reduzieren vermag (6,9,10,30,33).…”

Section: Koronare Herzkrankheit Und Linksventrikuläre Hypertrophieunclassified

Obstructive sleep apnea syndrome - diagnostics

Hader

Sanner²,

Rasche³

2004

Dtsch med Wochenschr

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DefinitionUnter obstruktiver Schlafapnoe/-hypopnoe wird ein periodisches Sistieren (Apnoe) oder eine periodische Reduktion (Hypopnoe) der Atmung bedingt durch eine komplette oder inkomplette Okklusion der oberen Atemwege im Schlaf mit daraus resultierender Weckreaktion (Arousal) bei fortbestehender Aktivität der Atmungsmuskulatur verstanden (Abb.1). Ein obstruktives Schlafapnoe-Syndrom (OSAS) liegt dann vor, wenn aufgrund der schlafbezogenen Atmungsstörung Folgesymptome entstehen. Als Leitsymptome des OSAS finden sich exzessive Tagesschläfrigkeit, lautes und unregelmäßiges Schnarchen und Atemstillstände während des Schlafens (1, 12, 13). Klassifikation schlafbezogener Atmungsstörungen

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Left Ventricular Hypertrophy Is a Common Echocardiographic Abnormality in Severe Obstructive Sleep Apnea and Reverses With Nasal Continuous Positive Airway Pressure*

Cited by 150 publications

References 46 publications

The effect of sibutramine-assisted weight loss in men with obstructive sleep apnoea

The effect of sibutramine-assisted weight loss in men with obstructive sleep apnoea

Sleep-Disordered Breathing

Obstructive sleep apnea syndrome - diagnostics

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