Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep MedicineJan 16, 2014

How Obstructive Sleep Apnea May Affect Heart Function and Shape in Patients Without Heart Failure

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Mar 29, 2026

Abstract

Patients with moderate to severe obstructive sleep apnea syndrome (OSAS) show significant cardiac dysfunction as measured by echocardiography.

Body mass index, neck circumference, Epworth Sleepiness Scale, desaturation index, arousal index, and snoring index were significantly higher in patients with moderate to severe OSAS.
Echocardiographic measures indicated that left atrial size, mitral A-wave velocity, and left ventricular end-diastolic volume were larger in patients with moderate to severe OSAS, while the E/A ratio was lower.
A higher apnea-hypopnea index (AHI) during REM sleep was significantly correlated with increased aortic root size, lower E/A ratio, and larger left ventricular volume and stroke volume.
An AHI in REM sleep of ≥ 32.3/h was associated with the development of left ventricular diastolic dysfunction, with an area under the curve of 0.647 for predicting this condition.
After adjusting for factors like age and body mass index, AHI in REM sleep ≥ 32.3/h remained the only independent predictor of diastolic dysfunction.

Simplified

STUDY OBJECTIVE: Obstructive sleep apnea syndrome (OSAS) has been considered to be an important predisposing factor for cardiovascular disease. This study aims to investigate the impact of OSAS on cardiac function and remodeling in patients without congestive heart failure.

METHODS: A total of 79 patients with sleep disordered breathing, preserved systolic function, and normal pro-brain natriuretic peptide level were enrolled. Sixty-five patients were classified to have moderate to severe OSAS (apnea-hypopnea index [AHI] ≥ 15/h), while the other 14 patients with mild or no OSAS (AHI < 15/h) served as control subjects. Baseline clinical and polysomnographic variables as well as tissue Doppler imaging and three-dimensional echocardiographic parameters were obtained.

RESULTS: The body mass index, neck circumference, Epworth Sleepiness Scale, desaturation index, arousal index, and snoring index were significantly higher in patients with moderate to severe OSAS than those without (p < 0.05). The left atrial size, mitral A-wave velocity, and left ventricular end-diastolic volume were significantly larger, while E/A ratio was lower in patients with moderate to severe OSAS than those without (p < 0.05). Notably, AHI in REM sleep was significantly correlated with the aortic root size, E/A ratio, left ventricular volume, and stroke volume. In addition, the area under the receiver operator characteristic curve for AHI in REM sleep ≥ 32.3/h was 0.647 (95% CI [0.525, 0.769]) in predicting the development of left ventricular diastolic dysfunction. AHI in REM sleep ≥ 32.3/h was the only independent variant in predicting diastolic dysfunction after adjusting the variables including age, gender, hypertension, and body mass index.

CONCLUSIONS: Patients with moderate to severe OSAS tend to have cardiac dysfunction revealed by echocardiography. High AHI in REM sleep is significantly associated with cardiovascular remodeling and ventricular diastolic dysfunction, and may be a potential variable to predict cardiac dysfunction.

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How Obstructive Sleep Apnea May Affect Heart Function and Shape in Patients Without Heart Failure

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