Journal of the American Society of Echocardiography
Left Atrial Volume and Function in Patients With Obstructive Sleep Apnea Assessed by Real-Time Three-Dimensional Echocardiography
Section snippets
Population
Fifty-six recently diagnosed, nontreated patients with OSA, aged 29 to 70 years (29 men), were recruited and referred to the Sleep Laboratory of the Federal University of São Paulo (São Paulo, Brazil). The diagnoses of OSA were confirmed by full polysomnography in conjunction with the requirement that patients present with apnea-hypopnea index values > 5 events/hour of sleep.
One hundred eighteen age-matched community subjects were invited to participate in this study as controls. The main
General Results
A total of 56 patients with mild to severe OSA and 50 control subjects without OSA were included in this study. As expected, the mean age did not significantly differ between groups, as shown in Table 1. Patients with OSA had greater neck circumferences compared with controls, but the frequencies of male gender, hypertension, and diabetes were similar in both groups. Additionally, BMI, heart rate, and systolic and diastolic blood pressure values were similar in both groups.
Polysomnographic Findings
The apnea-hypopnea
Discussion
The main findings of the current study were a significant increase in LA volume and augmentation of LA active systolic function associated with the impairment of left ventricular diastolic function in patients with OSA compared with controls as analyzed using RT3DE. Our study is the first to analyze subjects with OSA those without while controlling for confounding factors, such as hypertension and obesity, and the first to demonstrate LA functional differences between the 2 groups.
Conflicting
Conclusion
Using RT3DE, we demonstrated that OSA places a functional burden on the left atrium, resulting in remodeling. These functional and structural changes are related to diastolic impairment independent of hypertension, obesity, and diabetes mellitus. These patterns appear to increase according to OSA severity.
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This study was supported by Fundação de Apoio a Pesquisa do Estado de São Paulo; grants from Centros de Pesquisa, Inovação e Difusão; and Associação Fundo de Incentivo à Psicofarmacologia.