[Cardiac functional alterations and its risk factors in elderly patients with obstructive sleep apnea syndrome free of cardiovascular disease].

Nov 27, 2020Nan fang yi ke da xue xue bao = Journal of Southern Medical University

Heart function changes and their risk factors in older adults with obstructive sleep apnea but no heart disease

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Abstract

Patients with moderate to severe obstructive sleep apnea had a significantly lower E/A ratio (0.98±0.06) compared to those with mild obstructive sleep apnea (1.08±0.05).

Moderate to severe obstructive sleep apnea (OSA) is associated with higher hematocrit (0.22±0.08 vs. 0.17±0.04) and serum creatinine levels (70.94±27.88 vs. 54.49±34.22 μmol/L) compared to mild OSA.
Left ventricular function and structure parameters were similar between patients with mild and moderate to severe OSA.
Late diastolic mitral flow velocity (A) was significantly higher in moderate to severe OSA patients (70.35±6.87) than in mild OSA patients (64.09±8.31).
The early diastolic mitral flow velocity (E) was similar in both groups, but the E/A ratio was significantly lower in moderate to severe OSA patients (0.98±0.06 vs. 1.08±0.05).
The E/A ratio shows a negative correlation with the apnea-hypopnea index (β = -0.645), indicating potential diastolic function impairment in moderate to severe OSA.

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OBJECTIVE: To evaluate the changes of cardiac structure and function and their risk factors in elderly patients with obstructive sleep apnea syndrome (OSA) without cardiovascular complications.

METHODS: Eighty-two elderly OSA patients without cardiovascular disease admitted between January, 2015 and October, 2016 were enrolled in this study. According to their apnea-hypopnea index (AHI, calculated as the average number of episodes of apnoea and hypopnoea per hour of sleep), the patients were divided into mild OSA group (AHI < 15) and moderate to severe OSA group (AHI ≥ 15). The demographic data and the general clinical data were recorded and fasting blood samples were collected from the patients on the next morning following polysomnographic monitoring for blood cell analysis and biochemical examination. Echocardiography was performed within one week after overnight polysomnography, and the cardiac structure, cardiac function and biochemical indexes were compared between the two groups.

RESULTS: Compared with those with mild OSA group, the patients with moderate to severe OSA had significantly higher hematocrit (0.22±0.080.17±0.04,=0.032) and serum creatinine level (70.94± 27.8854.49±34.22 μmol/L,=0.022). The left ventricular ejection fraction, interventricular septal thickness, left ventricular posterior wall thickness, left atrial diameter and left ventricular end-diastolic diameter were all similar between the two groups. With a similar early diastolic mitral flow velocity (E) between the two groups, the patients with moderate to severe OSA had a significantly higher late diastolic mitral flow velocity (A) (70.35±6.8764.09±8.31,=0.0001) and a significantly lower E/A ratio (0.98±0.061.08±0.05,=0.0001) than the patients with mild OSA. Multiple linear regression showed that the E/A ratio was negatively correlated with AHI (β =- 0.645,=0.0001). vs P vs P vs P vs P P

CONCLUSIONS: Cardiac diastolic function impairment may occur in elderly patients with moderate or severe OSA who do not have hypertension or other cardiovascular diseases, and the severity of the impairment is positively correlated with AHI.

[Cardiac functional alterations and its risk factors in elderly patients with obstructive sleep apnea syndrome free of cardiovascular disease].

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