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The Impact of Sleep Apnea on Conventional Doppler Indices

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並列摘要


Objective: To prospectively explore the impact of obstructive sleep apnea (OSA) on conventional Doppler indices and to identify possible negative prognostic factors for left ventricular diastolic dysfunction. Materials and Methods: All included subjects had overnight polysomnography. All subjects underwent a comprehensive echocardiography examination to evaluate systolic and diastolic function of the left ventricle. A multiple logistic regression model was created to identify potential negative prognostic factors for left ventricular dysfunction. Results: A significant decrease in the ratio of early and atrial mitral flow velocity (E/A ratio) in OSA patients was found. Patients with moderate-tosevere OSA had a significant increase in the odds ratio for development of an abnormal E/A ratio (p=0.014, multivariate logistic regression). There was a significant negative correlation between E/A ratio and apnea-hypopnea index (p=0.01). Non-obese OSA patients and obese-OSA patients carried significantly increased odds ratios for the development of a reduced E/A ratio (p=0.02 and 0.038, respectively). Conclusion: Subjects with OSA had reduced mitral E/A ratios, which implies possible impaired diastolic heart function. Further study to reverse impaired diastolic function via lifestyle modifications and treatment with nasal continuous positive airway pressure or surgery is warranted.

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