title: Left ventricular diastolic dysfunction in obstructive sleep apnoea syndrome by an echocardiographic standardized approach: An observational study.
abstract: BACKGROUND
  The association between obstructive sleep apnoea syndrome (OSAS), left ventricular (LV) diastolic dysfunction and LV geometry remains controversial because of coexisting disorders.
  
  
  OBJECTIVE
  To evaluate LV diastolic dysfunction and its independent predictors in a real-life cohort of OSAS patients, by a standardized approach.
  
  
  METHODS
  We consecutively included 188 OSAS patients after an overnight polysomnography to undergo clinical evaluation, ambulatory blood pressure measurement and complete echocardiography, combining M-mode, two-dimensional Doppler and tissue Doppler imaging modes. Correlations between OSAS severity and clinical and echocardiographical variables were assessed, and logistic regression models were used to identify possible determining factors of LV diastolic dysfunction.
  
  
  RESULTS
  Most patients were hypertensive (n=148, 78.7%) and already receiving treatment by continuous positive airway pressure (n=158, 84.5%). The prevalence of LV hypertrophy, defined by LV mass index (LVMi) normalized by height (2.7), was 12.4%, with a significant correlation with hypertension (P=0.004). The apnoea-hypopnoea index was correlated with body mass index (P<0.0001), 24-hour systolic blood pressure (P=0.01) and LVMi normalized by height (2.7) (P=0.03). Diastolic function assessed by a global approach was impaired for 70 patients (37.2%) and none of the OSAS severity variables was a determining factor after multivariable analysis with adjustment for age and sex.
  
  
  CONCLUSIONS
  Diastolic dysfunction assessed by a standardized approach is common in OSAS and should be routinely evaluated; it is independently predicted by none of the respiratory severity variables.
authors.affiliation: Service de cardiologie, hôpital Saint-Antoine, Assistance publique-Hôpitaux de Paris, université Pierre-et-Marie-Curie, 184, rue du faubourg Saint-Antoine, 75571 Paris cedex 12, France.
authors.forename: Diane
authors.initials: D
authors.lastname: Bodez
authors.affiliation: Service de cardiologie, hôpital Saint-Antoine, Assistance publique-Hôpitaux de Paris, université Pierre-et-Marie-Curie, 184, rue du faubourg Saint-Antoine, 75571 Paris cedex 12, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Lang
authors.affiliation: Service de cardiologie, hôpital Saint-Antoine, Assistance publique-Hôpitaux de Paris, université Pierre-et-Marie-Curie, 184, rue du faubourg Saint-Antoine, 75571 Paris cedex 12, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Meuleman
authors.affiliation: Service de cardiologie, hôpital Saint-Antoine, Assistance publique-Hôpitaux de Paris, université Pierre-et-Marie-Curie, 184, rue du faubourg Saint-Antoine, 75571 Paris cedex 12, France.
authors.forename: Louise
authors.initials: L
authors.lastname: Boyer-Châtenet
authors.affiliation: Centre d'évaluation et traitements des troubles du sommeil, hôpital Saint-Antoine, Assistance publique-Hôpitaux de Paris, 184, rue du faubourg Saint-Antoine, 75571 Paris cedex 12, France.
authors.forename: Xuan-Lan
authors.initials: XL
authors.lastname: Nguyen
authors.affiliation: Service de cardiologie, hôpital Saint-Antoine, Assistance publique-Hôpitaux de Paris, université Pierre-et-Marie-Curie, 184, rue du faubourg Saint-Antoine, 75571 Paris cedex 12, France.
authors.forename: Laurie
authors.initials: L
authors.lastname: Soulat-Dufour
authors.affiliation: Service de cardiologie, hôpital Saint-Antoine, Assistance publique-Hôpitaux de Paris, université Pierre-et-Marie-Curie, 184, rue du faubourg Saint-Antoine, 75571 Paris cedex 12, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Boccara
authors.affiliation: Centre d'évaluation et traitements des troubles du sommeil, hôpital Saint-Antoine, Assistance publique-Hôpitaux de Paris, 184, rue du faubourg Saint-Antoine, 75571 Paris cedex 12, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Fleury
authors.affiliation: Service de cardiologie, hôpital Saint-Antoine, Assistance publique-Hôpitaux de Paris, université Pierre-et-Marie-Curie, 184, rue du faubourg Saint-Antoine, 75571 Paris cedex 12, France. Electronic address: ariel.cohen@aphp.fr.
authors.forename: Ariel
authors.initials: A
authors.lastname: Cohen
mesh_terms: D016009:Chi-Square Distribution; D045422:Continuous Positive Airway Pressure; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017286:Polysomnography; D011237:Predictive Value of Tests; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D016277:Ventricular Function, Left
keywords: Fonction diastolique ventriculaire gauche; Géométrie ventriculaire gauche; Left ventricular diastolic function; Left ventricular geometry; Obstructive sleep apnoea syndrome; Syndrome d’apnée du sommeil obstructif