title: Association between Obstructive Sleep Apnea and Left Ventricular Structure by Age and Gender: the Multi-Ethnic Study of Atherosclerosis.
abstract: OBJECTIVE
  The presence and severity of obstructive sleep apnea (OSA) are associated with impaired left ventricular (LV) structure and function. Our goal was to quantify the associations between LV systolic function and mass with severity of OSA in an ethnically diverse cohort, assessing variations by age and sex.
  
  
  METHODS
  We conducted a cross-sectional analysis of data from 1,412 racially/ethnically diverse participants across 6 US communities from the Multi-Ethnic Study of Atherosclerosis who underwent both overnight polysomnography and cardiac magnetic resonance imaging from 2010-2012. We evaluated the association between the obstructive apnea-hypopnea index (AHI) by clinical category (< 5, 5-15, 15-30, 30-50, > 50) and secondary measures of sleep apnea with the outcomes left ventricular (LV) mass adjusted for height, LV mass/volume ratio, and LV ejection fraction.
  
  
  RESULTS
  After adjusting for potential confounders and mediators, LV mass was significantly increased with increasing AHI category for subjects age 65 y or younger (β = 1.84 ± 0.47 g/m, P = 0.0001). The association between the AHI and LV mass appeared stronger in whites and Chinese compared to blacks and Hispanics, although interaction terms were not statistically significant. Additionally, while both LV mass and LV mass/volume ratio were significantly associated with hypoxia, ejection fraction was not associated with any OSA severity index. Comparable associations were observed in men and women.
  
  
  CONCLUSIONS
  Independent of confounders, higher levels of AHI are significantly associated with increased LV mass in both men and women younger than 65 y from a community-based cohort.
authors.affiliation: Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital; Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
authors.forename: Sogol
authors.initials: S
authors.lastname: Javaheri
authors.affiliation: Cardiology Division, Department of Medicine, Johns Hopkins Hospital, Baltimore, MD.
authors.forename: Ravi K
authors.initials: RK
authors.lastname: Sharma
authors.affiliation: Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital; Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
authors.forename: Rui
authors.initials: R
authors.lastname: Wang
authors.affiliation: Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital; Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
authors.forename: Jia
authors.initials: J
authors.lastname: Weng
authors.affiliation: Cardiology Division, Department of Medicine, Johns Hopkins Hospital, Baltimore, MD.
authors.forename: Boaz D
authors.initials: BD
authors.lastname: Rosen
authors.affiliation: Department of Radiology, Johns Hopkins University, Baltimore, MD.|Radiology and Imaging Sciences, National Institutes of Health (NIH), Bethesda, MD.
authors.forename: David A
authors.initials: DA
authors.lastname: Bluemke
authors.affiliation: Cardiology Division, Department of Medicine, Johns Hopkins Hospital, Baltimore, MD.|Department of Radiology, Johns Hopkins University, Baltimore, MD.
authors.forename: Joao A C
authors.initials: JA
authors.lastname: Lima
authors.affiliation: Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital; Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
authors.forename: Susan
authors.initials: S
authors.lastname: Redline
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis; D044383:Black People / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006352:Heart Ventricles / Q000473:pathology* / Q000503:physiopathology*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D044469:Racial Groups / Q000706:statistics & numerical data*; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology*; D014481:United States / Q000453:epidemiology; D016277:Ventricular Function, Left; D001741:Black or African American
keywords: cardiac magnetic resonance imaging; left ventricular mass; left ventricular mass/volume ratio; obstructive sleep apnea