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Left ventricular morphology and systolic function in sleep-disordered breathing: the Sleep Heart Health Study.
Tuesday,2012-11-06 12:09 America/Los_Angeles — eenright
| Title | Left ventricular morphology and systolic function in sleep-disordered breathing: the Sleep Heart Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 2008 |
| Authors | Chami, HA, Devereux, RB, Gottdiener, JS, Mehra, R, Roman, MJ, Benjamin, EJ, Gottlieb, DJ |
| Journal | Circulation |
| Volume | 117 |
| Issue | 20 |
| Pagination | 2599-607 |
| Date Published | 2008 May 20 |
| ISSN | 1524-4539 |
| Keywords | Aged, Echocardiography, Female, Humans, Hypertrophy, Left Ventricular, Hypoxia, Male, Middle Aged, Odds Ratio, Sleep Apnea Syndromes, Systole, Ventricular Dysfunction, Left |
| Abstract | <p><b>BACKGROUND: </b>Whether sleep-disordered breathing (SDB) is a risk factor for left ventricular (LV) hypertrophy and dysfunction is controversial. We assessed the relation of SDB to LV morphology and systolic function in a community-based sample of middle-aged and older adults.</p><p><b>METHODS AND RESULTS: </b>The present study was a cross-sectional observational study of 2058 Sleep Heart Health Study participants (mean age 65+/-12 years; 58% women; 44% ethnic minorities) who had technically adequate echocardiograms. A polysomnographically derived apnea-hypopnea index (AHI) and hypoxemia index (percent of sleep time with oxyhemoglobin saturation < 90%) were used to quantify SDB severity. LV mass index was significantly associated with both AHI and hypoxemia index after adjustment for age, sex, ethnicity, study site, body mass index, current and prior smoking, alcohol consumption, systolic blood pressure, antihypertensive medication use, diabetes mellitus, and prevalent myocardial infarction. Adjusted LV mass index was 41.3 (SD 9.90) g/m(2.7) in participants with AHI < 5 (n=957) and 44.1 (SD 9.90) g/m(2.7) in participants with AHI > or = 30 (n=84) events per hour. Compared with participants with AHI < 5, those with AHI > or = 30 had an adjusted odds ratio of 1.78 (95% confidence interval 1.14 to 2.79) for LV hypertrophy. A higher AHI and higher hypoxemia index were also associated with larger LV diastolic dimension and lower LV ejection fraction, with a trend toward lower LV fractional shortening. LV wall thickness was significantly associated with the hypoxemia index but not with AHI. Left atrial diameter was not associated with either SDB measure.</p><p><b>CONCLUSIONS: </b>In a community-based cohort, SDB is associated with echocardiographic evidence of increased LV mass and reduced LV systolic function.</p> |
| DOI | 10.1161/CIRCULATIONAHA.107.717892 |
| Alternate Journal | Circulation |
| PubMed ID | 18458174 |
| PubMed Central ID | PMC2813728 |
| Grant List | N01-HC-25195 / HC / NHLBI NIH HHS / United States HL-65521 / HL / NHLBI NIH HHS / United States U01 HL053934-14 / HL / NHLBI NIH HHS / United States R01 NS017950 / NS / NINDS NIH HHS / United States U01 HL041642 / HL / NHLBI NIH HHS / United States U01HL53937 / HL / NHLBI NIH HHS / United States U01 HL053931-10 / HL / NHLBI NIH HHS / United States U01 HL053916 / HL / NHLBI NIH HHS / United States U01 HL041642-19 / HL / NHLBI NIH HHS / United States U01 HL063463-09 / HL / NHLBI NIH HHS / United States U01 HL041654 / HL / NHLBI NIH HHS / United States U01 HL041654-20 / HL / NHLBI NIH HHS / United States N01-HC85086 / HC / NHLBI NIH HHS / United States HL-41642 / HL / NHLBI NIH HHS / United States R01 HL075078 / HL / NHLBI NIH HHS / United States N01-HC85079 / HC / NHLBI NIH HHS / United States U01 HL-080295 / HL / NHLBI NIH HHS / United States HL-30605 / HL / NHLBI NIH HHS / United States U01 HL053941-09 / HL / NHLBI NIH HHS / United States U01HL64360 / HL / NHLBI NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States U01 HL063463 / HL / NHLBI NIH HHS / United States N01-HC85083 / HC / NHLBI NIH HHS / United States U01 HL063429-09 / HL / NHLBI NIH HHS / United States N01 HC075150 / HC / NHLBI NIH HHS / United States U01 HL053916-14 / HL / NHLBI NIH HHS / United States U01 HL065521-08 / HL / NHLBI NIH HHS / United States U01HL53938 / HL / NHLBI NIH HHS / United States U01 HL080295-05 / HL / NHLBI NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States P01 HL047540 / HL / NHLBI NIH HHS / United States N01 HC025195 / HC / NHLBI NIH HHS / United States U01 HL064360-09 / HL / NHLBI NIH HHS / United States R01 NS017950-28 / NS / NINDS NIH HHS / United States R01 HL080124-05 / HL / NHLBI NIH HHS / United States U01 HL053938 / HL / NHLBI NIH HHS / United States U01 HL041652 / HL / NHLBI NIH HHS / United States HL080124 / HL / NHLBI NIH HHS / United States U01 HL053941-14 / HL / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States U01HL53934 / HL / NHLBI NIH HHS / United States U01 HL064360 / HL / NHLBI NIH HHS / United States U01 HL053940-05 / HL / NHLBI NIH HHS / United States N01-HC85082 / HC / NHLBI NIH HHS / United States 2U01-HL53941 / HL / NHLBI NIH HHS / United States HL-41654 / HL / NHLBI NIH HHS / United States 6R01-NS-17950 / NS / NINDS NIH HHS / United States U01 HL041652-20 / HL / NHLBI NIH HHS / United States U01 HL053941 / HL / NHLBI NIH HHS / United States U01 HL053937-14 / HL / NHLBI NIH HHS / United States N01-HC-75150 / HC / NHLBI NIH HHS / United States U01HL63429 / HL / NHLBI NIH HHS / United States U01HL53931 / HL / NHLBI NIH HHS / United States N01-HC85081 / HC / NHLBI NIH HHS / United States U01HL53941 / HL / NHLBI NIH HHS / United States U01 HL053934 / HL / NHLBI NIH HHS / United States U01HL53916 / HL / NHLBI NIH HHS / United States U01 HL063429 / HL / NHLBI NIH HHS / United States N01HC75150 / HL / NHLBI NIH HHS / United States N01-HC85085 / HC / NHLBI NIH HHS / United States N01-HC85080 / HC / NHLBI NIH HHS / United States HL-41652 / HL / NHLBI NIH HHS / United States N01HC25195 / HL / NHLBI NIH HHS / United States U01 HL065521 / HL / NHLBI NIH HHS / United States HL-47540 / HL / NHLBI NIH HHS / United States U01 HL053938-14 / HL / NHLBI NIH HHS / United States N01-HC85084 / HC / NHLBI NIH HHS / United States R01 HL080124 / HL / NHLBI NIH HHS / United States U01 HL053937 / HL / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States N01 HC085079 / HC / NHLBI NIH HHS / United States N01 HC045133 / HC / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States U01HL53940 / HL / NHLBI NIH HHS / United States U01HL63463 / HL / NHLBI NIH HHS / United States N01-HC-5222 / HC / NHLBI NIH HHS / United States U01 HL053931 / HL / NHLBI NIH HHS / United States |