The Impact of Sleep Apnea on Conventional Doppler Indices

Abstract 

Objective

To prospectively explore the impact of obstructive sleep apnea (OSA) on conventional Doppler indices and to identify possible negative prognostic factors for left ventricular diastolic dysfunction. Materials and Methods: All included subjects had overnight polysomnog-raphy. All subjects underwent a comprehensive echocardiography examination to evaluate systolic and diastolic function of the left ventricle. A multiple logistic regression model was created to identify potential negative prognostic factors for left ventricular dysfunction.

Results

A significant decrease in the ratio of early and atrial mitral flow velocity (E/A ratio) in OSA patients was found. Patients with moderate-to-severe OSA had a significant increase in the odds ratio for development of an abnormal E/A ratio (p=0.014, multivariate logistic regression). There was a significant negative correlation between E/A ratio and apnea-hypopnea index (p = 0.01). Non-obese OSA patients and obese-OSA patients carried significantly increased odds ratios for the development of a reduced E/A ratio (p = 0.02 and 0.038, respectively).

Conclusion

Subjects with OSA had reduced mitral E/A ratios, which implies possible impaired diastolic heart function. Further study to reverse impaired diastolic function via lifestyle modifications and treatment with nasal continuous positive airway pressure or surgery is warranted.

Keywords:  Diastolic function , Echocardiography , Obstructive sleep apnea

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