Association between obstructive sleep apnea and left ventricular remodeling: Geometry pattern and a gender effect

WANG Rui; HUANG Bi-xia; LIANG Ying-cong; ZHANG Jia-wei; CHEN Ji-yan; WANG Ling

摘要：Background Previous studies have suggested an association between obstructive sleep apnea (OSA) and left ventricular (LV) remodeling,but it remains unclear whether there's a specific remodeling pattern related to the OSA.Methods This study was a cross-sectional study of 1377 cardiovascular disease (CVD) patients.Respiratory events during sleep were recorded by portable monitors and apnea hypopnea index (AHI) was used to quantify OSA severity.Echocardiography was used to assess left ventricular structure.The left ventricular geometry was divided into four groups according to left ventricular mass index (LVMI) and relative wall thickness (RWT):normal geometry,concentric remodeling,concentric hypertrophy and eccentric hypertrophy.Results The prevalence of OSA was significantly higher in patients with abnormal left ventricular geometry (75.2％ vs.68.9％,P=0.012).Compared to patients with AHI ＜ 5,those with AHI ≥ 30 had an odds ratio of 1.53 (95％CI:1.03-2.28) for LV hypertrophy in male patients,after adjustment for age,body mass index,hypertension,diabetes,coronary artery disease and metabolism syndrome.Furthermore,after adjustment for confounding factor,severe OSA (compared with non-OSA) was significantly associated with the increased risk of eccentric hypertrophy in men (OR:2.34,95％CI:1.23-4.44).No association was observed between OSA and other types of LV remodeling in neither men or women.Conclusions OSA is implicated in LV remodeling and severe OSA is independently associated with a higher risk of eccentric LV hypertrophy in male patients.