Echocardiographic Findings in Healthy Elderly People with Unrecognized Sleep Disordered Breathing
Emilia Sforza, Mouhamed Sabri, Antoine DaCosta, Karl Isaaz, Jean Claude Barthélémy, Frédéric Roche, Emilia Sforza, Mouhamed Sabri, Antoine DaCosta, Karl Isaaz, Jean Claude Barthélémy, Frédéric Roche
Abstract
Objective: Sleep disordered breathing (SDB) is associated with cardiovascular disease such as hypertension and left ventricular hypertrophy in middle-aged patients; however, this association is not well described in the elderly. The aim of this study was to evaluate the impact of unrecognized SDB on cardiac function and remodeling in a population-based sample of healthy elderly without cardiac disease.
Methodology: A total of 405 healthy elderly (age ≥ 65 years) were examined by echocardiography and respiratory polygraphy. According to the apnea-hypopnea index (AHI), subjects were stratified in four categories: snorers (AHI < 5), mild (AHI: 5-15), moderate (AHI: 15-30), and severe (AHI > 30) cases.
Results: Comparative analysis between snorers and SDB cases revealed that left atrial (LA) diameter and surface increased according to SDB severity (p < 0.05) without differences in LA mass index. In subjects with an AHI > 30, an increase was found for LV end-diastolic and end-systolic dimension (p < 0.001), as well as for LV mass (p < 0.03) and LV index (p < 0.05). The current study showed a weak but significant correlation between altered LA and LV measurements versus AHI and hypoxemia indices (p < 0.001). In the regression analysis, AHI and hypoxemia had a minimal effect, body mass index and male gender being the most significant predictors.
Conclusions: In a population of healthy elderly with SDB, slight changes in left atrial and ventricular measurements occur in severe cases (AHI > 30). Irrespective of the lack of a strong association between SDB and cardiac dysfunction, the presence of slight cardiac pathology in severe SDB cases might be considered.
Clinical trial registration: NCT 00759304 and NCT 00766584.
Trial registration: ClinicalTrials.gov NCT00759304 NCT00766584.
Keywords: echocardiography; elderly; hypoxemia; left cardiac function; obesity; sleep disordered breathing.
© 2015 American Academy of Sleep Medicine.
Source: PubMed