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Abnormal atrial function in hypertensive patients with obstructive sleep apnea assessed by speckle tracking echocardiography

Hypertension Research volume 43, pages 841–844 (2020)Cite this article

Hypertension is a well-known risk factor for heart remodeling and atrial fibrillation, and there is growing interest in exploring the potential role of the influence of obstructive sleep apnea (OSA) in these mechanisms [1]. OSA is characterized by recurrent upper airway obstructions promoting inspiratory efforts against the occluded pharynx and causing abrupt reductions in intrathoracic pressure, which in turn increase left ventricular transmural pressure. Beyond the mechanical response, OSA also triggers recurrent hypoxia, hypercapnia and sleep fragmentation [2]. These OSA components may contribute to promoting blood pressure instability and have a significant impact on heart remodeling over time [3].

More severe forms of OSA are associated with heart remodeling [4] in patients with hypertension. However, the literature evaluating the impact of OSA on the heart structure has limited their analysis to linear measurements and Doppler-derived indexes in transthoracic echocardiography as well as left atrial diameter or left atrial area calculations [4].

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References

  1. Altekin RE, Yanikoglu A, Baktir AO, Karakas MS, Ozel D, Cilli A, et al. Assessment of subclinical left ventricular dysfunction in obstructive sleep apnea patients with speckle tracking echocardiography. Int J Cardiovasc Imaging. 2012;28:1917–30.

    Article  Google Scholar 

  2. Jordan AS, McSharry DG, Malhotra A. Adult obstructive sleep apnoea. Lancet. 2014;383:736–47.

    Article  Google Scholar 

  3. Javaheri S, Barbe F, Campos-Rodriguez F, Dempsey JA, Khayat R, Javaheri S, et al. Sleep apnea: types, mechanisms, and clinical cardiovascular consequences. J Am Coll Cardiol. 2017;69:841–58.

    Article  Google Scholar 

  4. Drager LF, Bortolotto LA, Figueiredo AC, Silva BC, Krieger EM, Lorenzi-Filho G. Obstructive sleep apnea, hypertension, and their interaction on arterial stiffness and heart remodeling. Chest. 2007;131:1379–86.

    Article  Google Scholar 

  5. Iber C, Ancoli-Israel S, Chesson AL, Quan SF, American Academy of Sleep Medicine. The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. Westchester, IL: American Academy of Sleep Medicine; 2007.

  6. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28:1–39.e14.

    Article  Google Scholar 

  7. Hoit BD. Left atrial size and function: role in prognosis. J Am Coll Cardiol. 2014;63:493–505.

    Article  Google Scholar 

  8. Pathan F, D’Elia N, Nolan MT, Marwick TH, Negishi K. Normal ranges of left atrial strain by speckle-tracking echocardiography: a systematic review and meta-analysis. J Am Soc Echocardiogr. 2017;30:59–70.e58.

    Article  Google Scholar 

  9. Vural MG, Cetin S, Firat H, Akdemir R, Yeter E. Impact of continuous positive airway pressure therapy on left atrial function in patients with obstructive sleep apnoea: assessment by conventional and two-dimensional speckle-tracking echocardiography. Acta Cardiol. 2014;69:175–84.

    Article  Google Scholar 

  10. Altekin RE, Yanikoglu A, Karakas MS, Ozel D, Kucuk M, Yilmaz H, et al. Assessment of left atrial dysfunction in obstructive sleep apnea patients with the two dimensional speckle-tracking echocardiography. Clin Res Cardiol. 2012;101:403–13.

    Article  Google Scholar 

  11. Luers C, Trippel TD, Seelander S, Wachter R, Hasenfuss G, Lindhorst R, et al. Arterial stiffness and elevated left ventricular filling pressure in patients at risk for the development or a previous diagnosis of HF-A subgroup analysis from the DIAST-CHF study. J Am Soc Hypertens. 2017;11:303–13.

    Article  Google Scholar 

  12. Heinzer R, Vat S, Marques-Vidal P, Marti-Soler H, Andries D, Tobback N, et al. Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Respir Med. 2015;3:310–8.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

Supported by the Pronto Socorro Cardiologico de Pernambuco Hospital—PROCAPE.

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Authors and Affiliations

  1. Pronto Socorro Cardiológico de Pernambuco (PROCAPE), Universidade de Pernambuco, Recife, Brazil

    Mardson A. Medeiros, Ozeas L. Lins-Filho, Tarcya L. G. C. Patriota, José M. del Castillo, Carlos A. M. Silveira, Eugênio S. de Albuquerque & Rodrigo P. Pedrosa

  2. Instituto de Ciências Biológicas, Universidade de Pernambuco (UPE), Recife, Brazil

    Ulisses R. Montarroyos

  3. Hospital Memorial São José—Rede D’Or São Luiz, Recife, Brazil

    Rodrigo P. Pedrosa

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  1. Mardson A. Medeiros
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Correspondence to Rodrigo P. Pedrosa.

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Medeiros, M.A., Lins-Filho, O.L., Patriota, T.L.G.C. et al. Abnormal atrial function in hypertensive patients with obstructive sleep apnea assessed by speckle tracking echocardiography. Hypertens Res 43, 841–844 (2020). https://doi.org/10.1038/s41440-020-0415-3

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