Abstract P202: High Risk for Obstructive Sleep Apnea is Associated with Left Ventricular Diastolic Dysfunction in a Large Population of Middle-Aged Men without Overt Cardiac Symptoms
Background Obstructive sleep apnea (OSA) is prevalent among patients with cardiovascular disease (CVD). Severity of OSA is linked to left ventricular diastolic dysfunction (LVDD). The Berlin Questionnaire (BQ) is the most widely used questionnaire to screen for OSA. We aim to investigate whether a relationship exists between OSA risk using the BQ and LVDD in a large population of asymptomatic middle-aged men.
Methodology We evaluated 1540 participants less than 50 years of age in the Law Enforcement Cardiac Screening Program from 2008 to 2010. Subjects underwent an echo Doppler study to evaluate peak mitral inflow velocities at early (E) and late (A) diastole, transmitral E/A ratio and Tissue Doppler Imaging (TDI) of the left ventricular (LV) septum in the apical four chamber view. LVDD was defined as LV E/A <1, or LV TDI e’/a’ <1 or E/e’ ratio ≥ 12. High risk for OSA (OSA positive) was identified as 2 or more positive categories from the BQ. Since the BQ scoring accounts for hypertension and body mass index, we did not adjust for these variables in the analysis.
Results OSA positive is associated with LVDD in the study population. Of the 653 subjects who were OSA positive, 59.4% had LVDD compared to 48.7% of subjects who were OSA negative (p < 0.0001). When adjusted for self-reported diabetes mellitus, LV ejection fraction <50%, and LV hypertrophy defined as LV septum > 12mm, the association remained significant (p < 0.0001).
Conclusion High risk for OSA identified by the BQ is associated with LVDD. The use of the BQ in middle-aged men without overt cardiac symptoms can aid in the early detection of LVDD and should be used in CVD risk assessment.
- © 2013 by American Heart Association, Inc.