title: Relationship between diastolic ventricular dysfunction and subclinical sleep-disordered breathing in atrial fibrillation ablation candidates.
abstract: Sleep-disordered breathing (SDB) is recognized as a primary factor or mediator of atrial fibrillation (AF). We hypothesized that the severity of SDB among AF ablation candidates would be associated with left ventricular diastolic dysfunction (LVDD) even for subclinical SDB. A total of 246 patients hospitalized for initial pulmonary vein isolation (PVI) were analyzed. Known SDB cases were excluded. We measured the oxygen desaturation index (ODI) by pulse oximetry overnight as an indicator of SDB, and classified SDB severity by 3 % ODI as normal (ODI < 5 events/h), mild (ODI ≤ 5 to <15 events/h), or moderate-to-severe (ODI ≥15 events/h). The LVDD was assessed by echocardiography using combined categories with tissue Doppler imaging and left atrial (LA) volume measurement. Among the participants, 42 patients (17.1 %) had LVDD. The prevalence of LVDD increased with the SDB severity from 8.6 % (normal) to 12.7 % (mild) to 40.0 % (moderate-to-severe SDB) (p < 0.0001). In the multivariate logistic regression analysis, the odds ratio of having LVDD in the moderate-to-severe SDB group (ODI ≥ 15) vs. normal group (ODI < 5) was 5.96 (95 % CI, 2.10-19.00, P = 0.006). The presence of moderate-to-severe SDB in AF ablation candidates adversely affected LV diastolic function even during a subclinical state of SDB.
authors.affiliation: Department Cardiology, Tenri Hospital, Tenri, Nara, Japan. kaitani@tenriyorozu.jp.
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Kaitani
authors.affiliation: Department Cardiology, Tenri Hospital, Tenri, Nara, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Kondo
authors.affiliation: Division of Cardiology, Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Hanazawa
authors.affiliation: Department Cardiology, Tenri Hospital, Tenri, Nara, Japan.
authors.forename: Naoaki
authors.initials: N
authors.lastname: Onishi
authors.affiliation: Department Cardiology, Tenri Hospital, Tenri, Nara, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Hayama
authors.affiliation: Department Cardiology, Tenri Hospital, Tenri, Nara, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Tsujimura
authors.affiliation: Department Cardiology, Tenri Hospital, Tenri, Nara, Japan.
authors.forename: Maiko
authors.initials: M
authors.lastname: Kuroda
authors.affiliation: Department Cardiology, Tenri Hospital, Tenri, Nara, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Nishimura
authors.affiliation: Department Cardiology, Tenri Hospital, Tenri, Nara, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Yoshikawa
authors.affiliation: Department Cardiology, Tenri Hospital, Tenri, Nara, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Takahashi
authors.affiliation: Department Cardiology, Tenri Hospital, Tenri, Nara, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Amano
authors.affiliation: Department Cardiology, Tenri Hospital, Tenri, Nara, Japan.
authors.forename: Sari
authors.initials: S
authors.lastname: Imamura
authors.affiliation: Department Cardiology, Tenri Hospital, Tenri, Nara, Japan.
authors.forename: Yodo
authors.initials: Y
authors.lastname: Tamaki
authors.affiliation: Department Cardiology, Tenri Hospital, Tenri, Nara, Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Enomoto
authors.affiliation: Department Cardiology, Tenri Hospital, Tenri, Nara, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Miyake
authors.affiliation: Department Cardiology, Tenri Hospital, Tenri, Nara, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Tamura
authors.affiliation: Division of Cardiology, Shizuoka General Hospital, Shizuoka, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Motooka
authors.affiliation: Department Cardiology, Tenri Hospital, Tenri, Nara, Japan.
authors.forename: Chisato
authors.initials: C
authors.lastname: Izumi
authors.affiliation: Department Cardiology, Tenri Hospital, Tenri, Nara, Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Nakagawa
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D016279:Atrial Function, Left; D064752:Atrial Remodeling; D017115:Catheter Ablation; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D016015:Logistic Models; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010092:Oximetry; D011446:Prospective Studies; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery*; D012042:Registries; D012119:Respiration; D012307:Risk Factors; D012720:Severity of Illness Index; D012890:Sleep; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling
keywords: Atrial fibrillation; Left atrial remodeling; Left ventricular diastolic dysfunction; Sleep-disordered breathing