ISSN: 1223-1533

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EARLY LEFT VENTRICULAR SYSTOLIC DYSFUNCTION IS STILL RELATED TO THE OBSTRUCTIVE SLEEP APNEA


Authors: Lisulov Danica Popovic, Mirjana Krotin, Miodrag Vukcevic, Marija Zdravkovic, Ruzica Pokrajac, Jelena Saric




 

Most of the patients with OSA without other cardiovascular disease usually exhibit normal LV ejection fraction (LVEF); nevertheless they still may have LV systolic dysfunction. From January 2010 to November 2012, 159 consecutive patients with newly diagnosed OSA (mean age: 58 + - 11 years, minimal 21, maximal 75) who had no following exclusion criteria were enrolled in the study, in the  National center for Sleep medicine Bezanijska kosa.

Exclusion criteria were the following: (1) central sleep apnoea, (2) history of coronary artery disease or electrocardiographic changes suggestive of myocardial infarction, (3) global LV systolic dysfunction (LVEF < 50%) or a history of congestive heart failure, (4) atrial fibrillation, (5) moderate to severe valvular heart diseases,

(6) hypertrophic cardiomyopathy, (7) history of chronic obstructive pulmonary disease or asthma, (8) previously diagnosis of OSA, and/or the previous use of continuous positive airway pressure therapy. All patients had been complained of daytime sleepiness and/or loud snoring. In addition, a total of age matched 78 asymptomatic healthy subjects who did not have any cardiovascular and respiratory symptoms were enrolled as a control group. All patients had undergone overnight polysomnography to determine the presence and severity of OSA. Complete transthoracic echocardiogram had been also performed immediately after the awake on the next morning. The two investigated groups were age matches, considering aging bias in left ventricle diastolic  dysfunction.

 

Results are shown in Table 63.1.

 

 

Patients

Controls

t

p

 

X

SD

X

SD

 

 

LVEDDd

5,13

0,48

4,78

0,42

-5,43

0,000**

LVESDs

3,26

0,42

3,06

0,41

-3,48

0,001**

IVSd

1,12

0,14

0,97

0,13

-7,58

0,000**

PWd

1,06

0,15

0,95

0,11

-6,40

0,000**

EF (%)

65,47

6,73

65,91

7,26

0,46

0,646

FS (%)

36,29

5,373

36,51

5,899

0,29

0,771

MV flow Prop

0,04

0,02

0,03

0,02

-4,70

0,000**

Mitral lateral Scm/s

9,31

2,60

10,31

2,14

3,14

0,002**

Mitral septal Scm/s

8,43

1,80

8,81

1,46

1,63

0,104

 

Conclusion: Left ventricle systolic dysfunction in patients with OSA can clearly be seen by sensitive markers of Doppler tissue imaging.