The relationship between aortic stiffness and cardiac function in patients with obstructive sleep apnea, independently from systemic hypertension.
OBJECTIVE
We sought to evaluate aortic function and its relationship with left ventricular (LV) function in patients with obstructive sleep apnea syndrome (OSAS), with or without systemic hypertension.


METHODS
A total of 29 patients with OSAS, 28 patients with systemic hypertension without OSAS, and 19 patients having both disorders were chosen as a study group, and 29 participants without these two disorders were taken as the control group; none of the patients had a history of cardiac disease. All of them underwent echocardiography and polysomnography. Aortic strain and distensibility were calculated from the aortic diameters measured by echocardiography and blood pressure obtained by cuff-sphygmomanometer. Cardiac functions were determined using echocardiography comprising standard 2-dimensional and conventional Doppler and Doppler tissue imaging.


RESULTS
Aortic strain (mean +/- SD; 6.1 +/- 2.7% vs 6.4 +/- 2.4%, 4.7 +/- 1.8%, and 13.7 +/- 4.5%, P < .001, respectively) and distensibility (mean +/- SD 2.8 +/- 1.6 vs 2.5 +/- 0.9, 1.7 +/- 0.7, and 6.2 +/- 3.2 10(-6) cm(2) dyn(-1)P < .001, respectively) were significantly decreased in the patient groups (OSAS, hypertensive, and OSAS and hypertensive) compared with the control group. LV long-axis and diastolic functions were also impaired in the study group. There were good correlations between the aortic stiffness and LV function parameters. In a multivariate analysis, aortic strain was the parameter found to be most strongly associated both with the Doppler tissue imaging mean peak early/late diastolic velocity ratio and the LV mitral lateral annular plane systolic excursion.


CONCLUSIONS
Aortic stiffness parameters (aortic strain and distensibility), LV systolic long-axis function indicators (mitral lateral annular plane systolic excursion, peak systolic myocardial velocity at lateral annulus, peak systolic myocardial velocity at septal annulus), and Doppler tissue imaging-derived LV diastolic indices were found abnormal in patients with OSAS, hypertension, or both. Thus, subclinical cardiac dysfunction has been found in patients with OSAS independent from the systemic hypertension.
Tavil
Yusuf
Y
Department of Cardiology, Gazi University Medical School, Ankara, Turkey. yusuftavil@gmail.com <yusuftavil@gmail.com>
Kanbay
Asiye
A
Sen
Nihat
N
Ulukavak Ciftçi
Tansu
T
Abaci
Adnan
A
Yalçin
M Ridvan
MR
Köktürk
Oğuz
O
Cengel
Atiye
A
D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001783:Blood Flow Velocity / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology; D003971:Diastole; D015150:Echocardiography, Doppler / Q000379:methods*; D004548:Elasticity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology*; D017286:Polysomnography; D011379:Prognosis; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016277:Ventricular Function, Left / Q000502:physiology*