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Subclinical Changes in Cardiac Functional Parameters as Determined by Cardiovascular Magnetic Resonance (CMR) Imaging in Sleep Apnea and Snoring: Findings from UK Biobank

Background and Objectives: Obstructive sleep apnea (OSA) is a common disorder with an increased risk for left ventricular and right ventricular dysfunction. Most studies to date have examined populations with manifest cardiovascular disease using echocardiography to analyze ventricular dysfunction w...

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Autores principales: Curta, Adrian, Hetterich, Holger, Schinner, Regina, Lee, Aaron M., Sommer, Wieland, Aung, Nay, Sanghvi, Mihir M., Fung, Kenneth, Lukaschuk, Elena, Cooper, Jackie A., Paiva, José Miguel, Carapella, Valentina, Neubauer, Stefan, Piechnik, Stefan K., Petersen, Steffen E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8230102/
https://www.ncbi.nlm.nih.gov/pubmed/34072775
http://dx.doi.org/10.3390/medicina57060555
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author Curta, Adrian
Hetterich, Holger
Schinner, Regina
Lee, Aaron M.
Sommer, Wieland
Aung, Nay
Sanghvi, Mihir M.
Fung, Kenneth
Lukaschuk, Elena
Cooper, Jackie A.
Paiva, José Miguel
Carapella, Valentina
Neubauer, Stefan
Piechnik, Stefan K.
Petersen, Steffen E.
author_facet Curta, Adrian
Hetterich, Holger
Schinner, Regina
Lee, Aaron M.
Sommer, Wieland
Aung, Nay
Sanghvi, Mihir M.
Fung, Kenneth
Lukaschuk, Elena
Cooper, Jackie A.
Paiva, José Miguel
Carapella, Valentina
Neubauer, Stefan
Piechnik, Stefan K.
Petersen, Steffen E.
author_sort Curta, Adrian
collection PubMed
description Background and Objectives: Obstructive sleep apnea (OSA) is a common disorder with an increased risk for left ventricular and right ventricular dysfunction. Most studies to date have examined populations with manifest cardiovascular disease using echocardiography to analyze ventricular dysfunction with little or no reference to ventricular volumes or myocardial mass. Our aim was to explore these parameters with cardiac MRI. We hypothesized that there would be stepwise increase in left ventricular mass and right ventricular volumes from the unaffected, to the snoring and the OSA group. Materials and Methods: We analyzed cardiac MRI data from 4978 UK Biobank participants free from cardiovascular disease. Participants were allocated into three cohorts: with OSA, with self-reported snoring and without OSA or snoring (n = 118, 1886 and 2477). We analyzed cardiac parameters from balanced cine-SSFP sequences and indexed them to body surface area. Results: Patients with OSA were mostly males (47.3% vs. 79.7%; p < 0.001) with higher body mass index (25.7 ± 4.0 vs. 31.3 ± 5.3 kg/m²; p < 0.001) and higher blood pressure (135 ± 18 vs. 140 ± 17 mmHg; p = 0.012) compared to individuals without OSA or snoring. Regression analysis showed a significant effect for OSA in left ventricular end-diastolic index (LVEDVI) (β = −4.9 ± 2.4 mL/m²; p = 0.040) and right ventricular end-diastolic index (RVEDVI) (β = −6.2 ± 2.6 mL/m²; p = 0.016) in females and for right ventricular ejection fraction (RVEF) (β = 1.7 ± 0.8%; p = 0.031) in males. A significant effect was discovered in snoring females for left ventricular mass index (LVMI) (β = 3.5 ± 0.9 g/m²; p < 0.001) and in males for left ventricular ejection fraction (LVEF) (β = 1.0 ± 0.3%; p = 0.001) and RVEF (β = 1.2 ± 0.3%; p < 0.001). Conclusion: Our study suggests that OSA is highly underdiagnosed and that it is an evolving process with gender specific progression. Females with OSA show significantly lower ventricular volumes while males with snoring show increased ejection fractions which may be an early sign of hypertrophy. Separate prospective studies are needed to further explore the direction of causality.
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spelling pubmed-82301022021-06-26 Subclinical Changes in Cardiac Functional Parameters as Determined by Cardiovascular Magnetic Resonance (CMR) Imaging in Sleep Apnea and Snoring: Findings from UK Biobank Curta, Adrian Hetterich, Holger Schinner, Regina Lee, Aaron M. Sommer, Wieland Aung, Nay Sanghvi, Mihir M. Fung, Kenneth Lukaschuk, Elena Cooper, Jackie A. Paiva, José Miguel Carapella, Valentina Neubauer, Stefan Piechnik, Stefan K. Petersen, Steffen E. Medicina (Kaunas) Article Background and Objectives: Obstructive sleep apnea (OSA) is a common disorder with an increased risk for left ventricular and right ventricular dysfunction. Most studies to date have examined populations with manifest cardiovascular disease using echocardiography to analyze ventricular dysfunction with little or no reference to ventricular volumes or myocardial mass. Our aim was to explore these parameters with cardiac MRI. We hypothesized that there would be stepwise increase in left ventricular mass and right ventricular volumes from the unaffected, to the snoring and the OSA group. Materials and Methods: We analyzed cardiac MRI data from 4978 UK Biobank participants free from cardiovascular disease. Participants were allocated into three cohorts: with OSA, with self-reported snoring and without OSA or snoring (n = 118, 1886 and 2477). We analyzed cardiac parameters from balanced cine-SSFP sequences and indexed them to body surface area. Results: Patients with OSA were mostly males (47.3% vs. 79.7%; p < 0.001) with higher body mass index (25.7 ± 4.0 vs. 31.3 ± 5.3 kg/m²; p < 0.001) and higher blood pressure (135 ± 18 vs. 140 ± 17 mmHg; p = 0.012) compared to individuals without OSA or snoring. Regression analysis showed a significant effect for OSA in left ventricular end-diastolic index (LVEDVI) (β = −4.9 ± 2.4 mL/m²; p = 0.040) and right ventricular end-diastolic index (RVEDVI) (β = −6.2 ± 2.6 mL/m²; p = 0.016) in females and for right ventricular ejection fraction (RVEF) (β = 1.7 ± 0.8%; p = 0.031) in males. A significant effect was discovered in snoring females for left ventricular mass index (LVMI) (β = 3.5 ± 0.9 g/m²; p < 0.001) and in males for left ventricular ejection fraction (LVEF) (β = 1.0 ± 0.3%; p = 0.001) and RVEF (β = 1.2 ± 0.3%; p < 0.001). Conclusion: Our study suggests that OSA is highly underdiagnosed and that it is an evolving process with gender specific progression. Females with OSA show significantly lower ventricular volumes while males with snoring show increased ejection fractions which may be an early sign of hypertrophy. Separate prospective studies are needed to further explore the direction of causality. MDPI 2021-05-31 /pmc/articles/PMC8230102/ /pubmed/34072775 http://dx.doi.org/10.3390/medicina57060555 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Curta, Adrian
Hetterich, Holger
Schinner, Regina
Lee, Aaron M.
Sommer, Wieland
Aung, Nay
Sanghvi, Mihir M.
Fung, Kenneth
Lukaschuk, Elena
Cooper, Jackie A.
Paiva, José Miguel
Carapella, Valentina
Neubauer, Stefan
Piechnik, Stefan K.
Petersen, Steffen E.
Subclinical Changes in Cardiac Functional Parameters as Determined by Cardiovascular Magnetic Resonance (CMR) Imaging in Sleep Apnea and Snoring: Findings from UK Biobank
title Subclinical Changes in Cardiac Functional Parameters as Determined by Cardiovascular Magnetic Resonance (CMR) Imaging in Sleep Apnea and Snoring: Findings from UK Biobank
title_full Subclinical Changes in Cardiac Functional Parameters as Determined by Cardiovascular Magnetic Resonance (CMR) Imaging in Sleep Apnea and Snoring: Findings from UK Biobank
title_fullStr Subclinical Changes in Cardiac Functional Parameters as Determined by Cardiovascular Magnetic Resonance (CMR) Imaging in Sleep Apnea and Snoring: Findings from UK Biobank
title_full_unstemmed Subclinical Changes in Cardiac Functional Parameters as Determined by Cardiovascular Magnetic Resonance (CMR) Imaging in Sleep Apnea and Snoring: Findings from UK Biobank
title_short Subclinical Changes in Cardiac Functional Parameters as Determined by Cardiovascular Magnetic Resonance (CMR) Imaging in Sleep Apnea and Snoring: Findings from UK Biobank
title_sort subclinical changes in cardiac functional parameters as determined by cardiovascular magnetic resonance (cmr) imaging in sleep apnea and snoring: findings from uk biobank
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8230102/
https://www.ncbi.nlm.nih.gov/pubmed/34072775
http://dx.doi.org/10.3390/medicina57060555
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