title: Left ventricle remodelling is associated with sleep-disordered breathing in non-ischaemic cardiopathy with systolic dysfunction.
abstract: Sleep-disordered breathing (SDB) is associated with left ventricle (LV) remodelling in patients with normal LV function. Sleep-disordered breathing is common in chronic heart failure (CHF) with systolic LV dysfunction, and may contribute to LV remodelling and CHF progression. Our aim was to determine the consequence of SDB on LV geometry in patients with CHF. We hypothesised that SDB severity was correlated with the degree of LV hypertrophy (LVH). One-hundred and sixty patients with CHF with a non-ischaemic systolic LV dysfunction were assessed by overnight polygraphy and echocardiography. Patients were classified in four groups according to their apnoea-hypopnoea index (AHI): <5 (no-SDB); 5-14 (mild); 15-29 (moderate); ≥30 (severe). Left ventricular mass index (LVM Ind) was calculated using the usual echocardiographic M-Mode parameters. Their mean age, New York Heart Association and left ventricular ejection fraction were, respectively: 56 ± 13 years, 2.4 ± 0.8 and 30 ± 10%, and 77% were men. Body mass index, interventricular septal and posterior LV wall thicknesses, and LVM Ind were significantly increased in severe SDB versus no-SDB. LVM Ind was correlated to the AHI (R = 0.27, P = 0.0006) and, using logistic regression, AHI was the unique independent factor of LVH in this population. In non-ischaemic CHF, SDB severity is associated with LV remodelling.
authors.affiliation: Federation de Cardiologie, AP-HP, Groupe Henri-Mondor Albert-Chenevier, Créteil, France. thibaud.damy@hmn.aphp.fr
authors.forename: Thibaud
authors.initials: T
authors.lastname: Damy
authors.forename: Alexandra
authors.initials: A
authors.lastname: Paulino
authors.forename: Laurent
authors.initials: L
authors.lastname: Margarit
authors.forename: Xavier
authors.initials: X
authors.lastname: Drouot
authors.forename: Maria
authors.initials: M
authors.lastname: Stoica
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Vermes
authors.forename: Pascal
authors.initials: P
authors.lastname: Gueret
authors.forename: Serge
authors.initials: S
authors.lastname: Adnot
authors.forename: Jean-Luc Dubois
authors.initials: JL
authors.lastname: Rande
authors.forename: Marie-Pia
authors.initials: MP
authors.lastname: D'Ortho
authors.forename: Luc
authors.initials: L
authors.lastname: Hittinger
mesh_terms: D015992:Body Mass Index; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000150:complications*; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D020257:Ventricular Remodeling / Q000502:physiology