Left ventricular geometry in patients with obstructive sleep apnea coexisting with treated systemic hypertension.
BACKGROUND
Left ventricular (LV) hypertrophy is a common consequence of systemic hypertension (SH) and obstructive sleep apnea (OSA). However, little is known about the degree of LV involvement in patients with OSA coexisting with treated SH.


OBJECTIVE
Our study was designed in order to assess the prevalence of distinct types of LV geometry in treated hypertensive OSA patients.


METHODS



METHODS
183 patients with treated SH were enrolled to the study. Group 1 consisted of 38 patients with newly-diagnosed OSA and ineffectively treated SH. The remaining 145 patients with effectively treated SH were divided into three groups: group 2 - 70 patients with newly-diagnosed OSA, group 3 - 31 patients with OSA treated with continuous positive airway pressure (CPAP), and group 4 - 44 patients without OSA. Overnight sleep studies and M-mode echocardiography were performed.


RESULTS
LV mass index did not differ between the study groups. Mean values of LV end-diastolic diameter (LVED) were 55.4 +/- 6.8 mm in group 1 and 53.6 +/- 6.9 mm in group 2 and were significantly increased in comparison to subjects treated with CPAP and controls (49.8 +/- 6.8 mm and 50.1 +/- 64.7 mm, respectively; p = 0.001). LVED correlated positively with the apnea-hypopnea index and desaturation index. LV eccentric hypertrophy was the commonest type of LV geometry in newly-diagnosed OSA patients.


CONCLUSIONS
The major finding of our study is the predominance of LV eccentric hypertrophy in newly-diagnosed OSA patients. We suggest that a relatively moderate degree of LV involvement in hypertensive OSA patients may depend on the cardioprotective effect of concomitant antihypertensive therapy, ameliorating OSA-dependent neurohumoral abnormalities.
Myslinski
Wojciech
W
Department of Internal Medicine, University School of Medicine, Lublin, Poland. misl@poczta.wprost.pl
Duchna
Hans-Werner
HW
Rasche
Kurt
K
Dichmann
Manuel
M
Mosiewicz
Jerzy
J
Schultze-Werninghaus
Gerhard
G
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000502:physiology; D004452:Echocardiography; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D013318:Stroke Volume / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology
D000959:Antihypertensive Agents