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Multicenter Study
. 2020 May;13(5):e009074.
doi: 10.1161/CIRCIMAGING.119.009074. Epub 2020 May 15.

Association Between Sleep Disordered Breathing and Left Ventricular Function: A Cross-Sectional Analysis of the ECHO-SOL Ancillary Study

Affiliations
Multicenter Study

Association Between Sleep Disordered Breathing and Left Ventricular Function: A Cross-Sectional Analysis of the ECHO-SOL Ancillary Study

Rachel P Ogilvie et al. Circ Cardiovasc Imaging. 2020 May.

Abstract

Background: Prior studies have found that sleep-disordered breathing (SDB) is common among those with left ventricular (LV) dysfunction and heart failure. Few epidemiological studies have examined this association, especially in US Hispanic/Latinos, who may be at elevated risk of SDB and heart failure.

Methods: We examined associations between SDB and LV diastolic and systolic function using data from 1506 adults aged 18 to 64 years in the Hispanic Community Health Study/Study of Latinos ECHO-SOL Ancillary Study (2011-2014). Home sleep testing was used to measure the apnea-hypopnea index, a measure of SDB severity. Echocardiography was performed a median of 2.1 years later to quantify LV diastolic function, systolic function, and structure. Multivariable linear regression was used to model the association between apnea-hypopnea index and echocardiographic measures while accounting for the complex survey design, demographics, body mass, and time between sleep and echocardiographic measurements.

Results: Each 10-unit increase in apnea-hypopnea index was associated with 0.2 (95% CI, 0.1-0.3) lower E', 0.3 (0.1-0.5) greater E/E' ratio, and 1.07-fold (1.03-1.11) higher prevalence of diastolic dysfunction as well as 1.3 (0.3-2.4) g/m2 greater LV mass index. These associations persisted after adjustment for hypertension and diabetes mellitus. In contrast, no association was identified between SDB severity and subclinical markers of LV systolic function.

Conclusions: Greater SDB severity was associated with LV hypertrophy and subclinical markers of LV diastolic dysfunction. These findings suggest SDB in Hispanic/Latino men and women may contribute to the burden of heart failure in this population.

Keywords: echocardiography; epidemiology; heart failure; risk factors; sleep.

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Figures

Figure 1.
Figure 1.
Adjusted measures and 95% confidence intervals of left ventricular function and structure by sleep disordered breathing severity: The ECHO-SOL Ancillary Study *Global longitudinal strain expressed as absolute value Models adjusted for age, sex, Hispanic/Latino background, study site, body mass index, and lag time LVDD – left ventricular diastolic dysfunction LVMI – left ventricular mass index LAVI – Left atrial volume index
Figure 1.
Figure 1.
Adjusted measures and 95% confidence intervals of left ventricular function and structure by sleep disordered breathing severity: The ECHO-SOL Ancillary Study *Global longitudinal strain expressed as absolute value Models adjusted for age, sex, Hispanic/Latino background, study site, body mass index, and lag time LVDD – left ventricular diastolic dysfunction LVMI – left ventricular mass index LAVI – Left atrial volume index

Comment in

References

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