OSA, metabolic syndrome and CPAP: Effect on cardiac remodeling in subjects with abdominal obesity

• Published in: Respiratory medicine Vol. 106; no. 1; pp. 145 - 152
• Main Authors: Grandi, Anna M, Laurita, Emanuela, Marchesi, Chiara, Maresca, Andrea M, Solbiati, Francesco, Bernasconi, Antonella, Marogna, Maurizio, Salina, Claudio, Nicolini, Eleonora, Guasti, Luigina, Colombo, Fausto, Venco, Achille
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.01.2012; Elsevier; Elsevier Limited
• Subjects: Abdomen; Abdominal obesity; Biological and medical sciences; Cardiovascular disease; Continuous positive airway pressure; Continuous Positive Airway Pressure - adverse effects; Cross-Sectional Studies; Diet; Echocardiography; Female; Flow velocity; Humans; Left ventricular hypertrophy; Lifestyles; Longitudinal Studies; Male; Medical sciences; Metabolic diseases; Metabolic syndrome; Metabolic Syndrome - complications; Metabolic Syndrome - pathology; Metabolic Syndrome - physiopathology; Middle Aged; Miscellaneous; Mortality; Obesity; Obesity, Abdominal - complications; Obesity, Abdominal - pathology; Obesity, Abdominal - physiopathology; Obstructive sleep apnoea; Other metabolic disorders; Pneumology; Pulmonary/Respiratory; Respiratory system : syndromes and miscellaneous diseases; Risk factors; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - pathology; Sleep Apnea, Obstructive - physiopathology; Statistical analysis; Ventricular Function, Left; Ventricular Remodeling; Abdominal obesity; Obstructive sleep apnoea; Metabolic syndrome; Continuous positive airway pressure; Left ventricular hypertrophy; Endocrinopathy; Heart; Human; Nervous system diseases; Sleep apnea syndrome; Respiratory disease; Continuous; Metabolic diseases; Cardiovascular disease; Artificial ventilation; Visceral obesity; Left ventricle; Vascular remodeling; Positive pressure; Mechanical ventilation; Hypertrophy; Pneumology
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/j.rmed.2011.10.006

Summary Background We evaluated whether obstructive sleep apnoea (OSA) and continuous positive airway pressure (CPAP) treatment influence left ventricular (LV) remodelling independently of abdominal obesity and metabolic syndrome (MetS). Methods Cardiorespiratory examination, 24-h BP monitoring and echocardiogram were performed in overweight/obese patients with increased abdominal adiposity and symptoms suggesting OSA : OSA/MetS (n.50), OSA/noMetS (n.22), noOSA/MetS (n.29), noOSA/noMets (n.16). The evaluation was repeated in 41 patients after ≥18 months of CPAP. Results Despite similar age, gender, BMI and 24-h BP, the 2 groups with MetS had greater LV remodelling (LV hypertrophy and diastolic dysfunction) than the 2 groups without MetS. From multiple regression analysis independent determinants for LV mass were MetS, 24-h systolic BP and age, for LV diastolic function were LV mass index, MetS and age. After CPAP, the 20 patients with decreased body weight showed diastolic BP decrease, LV hypertrophy regression and diastolic function improvement, whereas, despite similar respiratory improvement, BP and LV parameters were unchanged in the 21 patients with body weight unchanged/increased. Conclusion In patients with increased abdominal adiposity, LV remodelling is not associated to OSA per se; chronic CPAP treatment does not influence LV remodelling whose regression is mainly linked to body weight decrease.