Left ventricular subclinical dysfunction associated with myocardial deformation changes in obstructive sleep apnea patients estimated by real-time 3D speckle-tracking echocardiography

Wang, Dian; Ma, Gen Shan; Wang, Xiao Yan; Lü, Qiang; Wang, Yu; Liu, Nai Feng

doi:10.1007/s11325-015-1197-8

Cited by 19 publications

(14 citation statements)

References 40 publications

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“…In other words, 3D multidirectional strain gradually and significantly reduced from mild, across moderate, to severe OSA patients. 11 Additionally, 3D longitudinal, circumferential, radial, and area strain correlated well with AHI. However, LV mass index was increasing and LV ejection fraction, as well as LV diastolic parameters, was deteriorating in the same direction-from mild to severe OSA.…”

Section: Wang Et Al 11 Investigated 3d LV Multidirectional Strain In mentioning

confidence: 83%

“…with OSA and revealed that 3D LV longitudinal and area strain were significantly lower in the patients with moderate and severe OSA than in the control group and patients with mild OSA, 11 whereas 3D circumferential and radial strain were significantly reduced only in patients with severe OSA in comparison with controls. It should be emphasized that severe OSA patients had significantly lower all types of 3D strain in comparison to controls or mild and moderate OSA patients.…”

Section: Wang Et Al 11 Investigated 3d LV Multidirectional Strain In mentioning

confidence: 83%

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Obstructive sleep apnea and left ventricular strain: Useful tool or fancy gadget?

Cuspidi

Tadić

2019

J of Clinical Hypertension

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Obstructive sleep apnea (OSA) syndrome is the most common sleep-breathing disorder, which is characterized with snoring, interruptions in breading during sleeping, or daytime sleepiness, and choking or gasping during sleep. Polysomnography defined OSA as 5 or more episodes of obstructive apneas/hypopneas per hour during sleep. 1,2 There are many risk factors for OSA, but the most important is obesity, and therefore, many studies are devoted to the assessment of the influence of weight reduction in OSA. 3 It is also known that OSA increases risk of resistant arterial hypertension, coronary artery disease, heart failure, pulmonary hypertension, and various cardiovascular conditions. 4 Moreover, investigations demonstrated the association between OSA and cardiac remodeling. However, these studies were usually concentrated on left ventricular (LV) structure and function, which mainly included basic echocardiographic parameters such as LV hypertrophy, LV ejection fraction, and several basic parameters of LV diastolic (dys)function. 5 Investigations regarding LV mechanics in patients with OSA are scarce.Altekin et al 6 included 58 OSA patients with different severity of OSA. Patients were classified as mild OSA when the apnea-hypopnea index (AHI) was between 5 and 15, moderate OSA was diagnosed in patients with AHI between 15 and 30 and severe OSA was defined as AHI higher than 30. 6 The authors reported that main parameters of LV diastolic function (E/A, E/e′, mitral deceleration time, left atrial volume index) deteriorated gradually from mild to severe OSA. 6 More interestingly, the authors found gradual reduction in LV longitudinal strain from mild, across moderate, to severe OSA. The reduction in LV circumferential and radial strain was revealed in moderate and severe OSA patients, but not in those with mild OSA. However, strain rates referring to LV mechanics during early and late diastole also gradually deteriorated from mild to severe OSA in all three directions-longitudinal, circumferential, and radial. 6 The correlation between AHI and LV longitudinal strain and strain rates was significantly stronger than between AHI and parameters of LV diastolic function. 6 On the other hand, there was no correlation between AHI and LV ejection fraction and only weak correlation with LV mass index. 6 One should underline that there was no significant difference in body mass index (BMI) between three observed groups. However, the authors did not perform multivariate regression analysis including BMI in the model in order to exclude potential effect of obesity on the final results. Varghese et al 7 also reported significantly lower LV longitudinal strain in patients with severe OSA, but without significant difference in LV circumferential strain. LV longitudinal strain, but not circumferential strain, was found to correlate significantly with AHI. 7 Cho et al 8 included 25 patients with OSA and compared LV remodeling in these patients with healthy controls and obese patients, as well as the impact of bariatric surgery in pati...

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Section: Wang Et Al 11 Investigated 3d LV Multidirectional Strain In mentioning

confidence: 83%

Section: Wang Et Al 11 Investigated 3d LV Multidirectional Strain In mentioning

confidence: 83%

Obstructive sleep apnea and left ventricular strain: Useful tool or fancy gadget?

Cuspidi

Tadić

2019

J of Clinical Hypertension

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“…In 206 patients with AHI ≥ 5/h and without cardiac disease, hypertension, or diabetes, AHI was shown to be associated with higher E/e' [12]. Also, in 78 patients with obstructive sleep apnea without any comorbidities, disease severity tended to be associated with both LV diastolic dysfunction and abnormalities in regional systolic function with myocardial deformation changes, in spite of normal LV ejection fraction [13]. In a recent report of 1506 adults in the Hispanic Community Health Study/Study of Latinos ECHO-SOL Ancillary Study, greater AHI was associated cross-sectionally with subclinical markers of LV diastolic dysfunction (E/e') and LVMI [14].…”

Section: Sleep Apnea As Predictor Of Progression Of Cardiac Diastolicmentioning

confidence: 95%

Sleep Apnea and Diabetes Predict Progression of Cardiac Diastolic Dysfunction in Pre-heart Failure Patients: a Prospective Cohort HSCAA Study

Kidawara¹,

Kadoya²,

Morimoto³

et al. 2020

Preprint

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[Background] Sleep apnea, a common co-morbid condition of diabetes, has been shown to be associated with established heart failure. However, its role in association of the presence of diabetes in the progression of cardiac diastolic function in pre-heart failure phase is not known. This prospective study is to longitudinally examine the predictive value of sleep apnea and diabetes on progression of left ventricular (LV) diastolic dysfunction in patients without heart disease.[Methods] Among 976 patients registered in HSCAA prospective cohort study, 517 without heart disease (175 type 2 diabetes, 342 non-diabetes) were followed with repeated echocardiography in every 1-3 years for a mean 34.7 months. LV diastolic dysfunction was determined by transmitral early inflow velocity/early diastolic tissue velocity (E/e´) >14. Annual change in E/e’ was calculated by using the slope of the linear regression line calculated from at least 3 echocardiographic measurements. Sleep apnea was determined by an apnomonitor device in conjunction with percutaneous oxygen saturation, and apnea hypopnea index (AHI) was calculated.[Results] Kaplan-Meier analyses revealed that subjects with diabetes or sleep apnea had a significantly (p<0.01) greater risk for LV diastolic dysfunction, with hazards ratio of 2.21 (1.41-3.47) and 2.23 (1.40-3.55), respectively. Subjects with sleep apnea exhibited significantly higher risk for LV diastolic dysfunction in non-diabetic subjects (p<0.01), while showed tendency of higher risk in diabetic subjects (p=0.10). The annual change of E/e’ was significantly and independently associated with both diabetes (β=0.278, p<0.01) and AHI (β=0.138, p<0.01). Finally, ROC analyses revealed that addition of AHI and diabetes to classical risk factors best predicted individuals with fast progression of diastolic dysfunction (annual change of E/e’ >1.0) with an AUC of 0.81.[Conclusions] In patients without heart disease, sleep apnea is an important predictor for progression of LV diastolic dysfunction. Its association is partly confounded, but still independent of the presence of diabetes.

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“…Нет доказательств того, что ОАС само по себе связано с достоверным снижением ФВ ЛЖ у пациентов без явной сердечно-сосудистой патологии. В то же время выводы нескольких исследований свидетельствуют о связи между тяжестью ОАС и значением скорости кровотока в миокарде ЛЖ по данным тканевой допплерографии и оценки деформации миокарда (strain) -показатели систолической функции ЛЖ, которые более чувствительны, чем ФВ ЛЖ [11][12][13]. Влияние ОАС на сердце схематично представлено на рисунке 1.…”

Section: мнение по проблемеunclassified

Obstructive Sleep Apnea as Cardiovascular Risk Factor: To Treat or Not?

Драпкина¹,

Дуболазова²,

Корнеева³

2017

Kardiovask. ter. profil.

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ФГБУ Государственный научно-исследовательский центр профилактической медицины Минздрава России. Москва; 2 ФГАОУ ВО "Первый Московский государственный медицинский университет имени И. М. Сеченова" Минздрава России (Сеченовский Университет). Москва; 3 ЗАО "Группа компаний "Медси". Москва, Россия В настоящее время доказано наличие взаимосвязи между обструктивным апноэ сна (ОаС) и повышенным риском сердечно-сосудистых заболеваний (ССз). Распространенность этих патологических процессов увеличивается с возрастом. если предрасполагающие факторы риска ССз достаточно изучены, и разработаны меры их профилактики, то факторы риска и профилактика ОаС требуют дальнейшего изучения. В частности, особый интерес представляет собой исследование влияния ОаС на развитие и течение сердечной недостаточности, а также эффективность и безопасность CPAP (continuous positive airway pressure) терапии у пациентов с различными фенотипами сердечной недостаточности. Результаты ряда исследований свидетельствуют о том, что пациенты с не леченным тяжелым ОаС имеют повышенный риск фатальных и нефатальных событий, по сравнению с людьми, которые храпят во сне. В обзоре представлены данные клинических исследований, отражающие современное состояние проблемы. Ключевые слова: обструктивное апноэ сна, ожирение, сердечнососудистые заболевания, сердечная недостаточность.Кардиоваскулярная терапия и профилактика, 2017; 16(3): 68-74 http://dx.

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Left ventricular subclinical dysfunction associated with myocardial deformation changes in obstructive sleep apnea patients estimated by real-time 3D speckle-tracking echocardiography

Cited by 19 publications

References 40 publications

Obstructive sleep apnea and left ventricular strain: Useful tool or fancy gadget?

Obstructive sleep apnea and left ventricular strain: Useful tool or fancy gadget?

Sleep Apnea and Diabetes Predict Progression of Cardiac Diastolic Dysfunction in Pre-heart Failure Patients: a Prospective Cohort HSCAA Study

Obstructive Sleep Apnea as Cardiovascular Risk Factor: To Treat or Not?

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Left ventricular subclinical dysfunction associated with myocardial deformation changes in obstructive sleep apnea patients estimated by real-time 3D speckle-tracking echocardiography

Cited by 19 publications

References 40 publications

Obstructive sleep apnea and left ventricular strain: Useful tool or fancy gadget?

Obstructive sleep apnea and left ventricular strain: Useful tool or fancy gadget?

Sleep Apnea and Diabetes Predict Progression of Cardiac Diastolic Dysfunction in Pre-heart Failure Patients: a Prospective Cohort HSCAA&nbsp;Study

Obstructive Sleep Apnea as Cardiovascular Risk Factor: To Treat or Not?

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Sleep Apnea and Diabetes Predict Progression of Cardiac Diastolic Dysfunction in Pre-heart Failure Patients: a Prospective Cohort HSCAA Study