title: OSA, metabolic syndrome and CPAP: effect on cardiac remodeling in subjects with abdominal obesity.
abstract: BACKGROUND
  We evaluated whether obstructive sleep apnoea (OSA) and continuous positive airway pressure (CPAP) treatment influence left ventricular (LV) remodelling independently of abdominal obesity and metabolic syndrome (MetS).
  
  
  METHODS
  Cardiorespiratory examination, 24-h BP monitoring and echocardiogram were performed in overweight/obese patients with increased abdominal adiposity and symptoms suggesting OSA : OSA/MetS (n.50), OSA/noMetS (n.22), noOSA/MetS (n.29), noOSA/noMets (n.16). The evaluation was repeated in 41 patients after ≥18 months of CPAP.
  
  
  RESULTS
  Despite similar age, gender, BMI and 24-h BP, the 2 groups with MetS had greater LV remodelling (LV hypertrophy and diastolic dysfunction) than the 2 groups without MetS. From multiple regression analysis independent determinants for LV mass were MetS, 24-h systolic BP and age, for LV diastolic function were LV mass index, MetS and age. After CPAP, the 20 patients with decreased body weight showed diastolic BP decrease, LV hypertrophy regression and diastolic function improvement, whereas, despite similar respiratory improvement, BP and LV parameters were unchanged in the 21 patients with body weight unchanged/increased.
  
  
  CONCLUSIONS
  In patients with increased abdominal adiposity, LV remodelling is not associated to OSA per se; chronic CPAP treatment does not influence LV remodelling whose regression is mainly linked to body weight decrease.
authors: Department of Clinical Medicine, University of Insubria, Varese, Italy. amgrandi@libero.it
authors: Anna M
authors: AM
authors: Grandi
authors: Emanuela
authors: E
authors: Laurita
authors: Chiara
authors: C
authors: Marchesi
authors: Andrea M
authors: AM
authors: Maresca
authors: Francesco
authors: F
authors: Solbiati
authors: Antonella
authors: A
authors: Bernasconi
authors: Maurizio
authors: M
authors: Marogna
authors: Claudio
authors: C
authors: Salina
authors: Eleonora
authors: E
authors: Nicolini
authors: Luigina
authors: L
authors: Guasti
authors: Fausto
authors: F
authors: Colombo
authors: Achille
authors: A
authors: Venco
mesh_terms: D045422:Continuous Positive Airway Pressure / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling