Abstract
We investigated whether OSA independently affects diastolic function in a primary care cohort of patients with cardiovascular risk factors.
378 study participants with risk factors for diastolic dysfunction (DD) were prospectively included and a polygraphy was performed in all patients. DD was assessed by comprehensive echocardiography including tissue Doppler. Sleep apnoea was classified according to apnoea/hypopnea index (AHI) as none (AHI <5), mild (5 ≤ AHI < 15) or moderate/severe (AHI ≥ 15·h−1).
Patients with central sleep apnoea (n=14) and patients with previously diagnosed sleep apnoea (n=12) were excluded. In the remaining 352 subjects, 21.6 % had an AHI ≥ 15·h−1. The prevalence of DD increased with the severity of sleep apnoea from 44.8 % (none) to 56.8 % (mild) to 69.7 % (moderate/severe sleep apnoea), p=0.002. The degree of DD also increased with sleep apnoea severity (p=0.004). In univariate regression analysis, age, desaturation index, AHI, heart rate, AT1 receptor antagonist therapy, body mass index and left ventricular mass were associated with DD. In multivariate regression analysis, only age, BMI, AHI and heart rate were independently associated with DD.
Moderate/severe obstructive sleep apnoea is independently associated with DD in patients with classical risk factors for diastolic dysfunction.
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