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New York Medical College, Valhalla, NY
PURPOSE: To investigate the prevalence of moderate or severe left ventricular diastolic dysfunction (LVDD) in obese persons with moderate or severe obstructive sleep apnea (OSA).
METHODS: We investigated prior to gastric bypass surgery the prevalence of LVDD by Doppler and tissue Doppler echocardiography in 14 obese women and in 6 obese men, mean age 45 years, who had nocturnal polysomnography for OSA. OSA was considered mild if the respiratory disturbance index (RDI) was 5-15, moderate if the RDI was 15-30, and severe if the RDI was >30. The Doppler echocardiographic data were analyzed blindly without knowledge of the clinical characteristics or whether OSA was present or absent.
RESULTS: Of the 20 persons, 8 (40%) had no OSA, 4 (20%) had mild OSA, and 8 (40%) had moderate or severe OSA. The mean age, body mass index, and prevalence of smoking, hypertension, diabetes mellitus, and hypercholesterolemia were not significantly different between 8 persons with moderate or severe OSA and 12 persons with no or mild OSA. Five of 8 persons (63%) with moderate or severe OSA and 1 of 12 persons (8%) with no or mild OSA were men (p<0.01). Moderate or severe LVDD was present in 4 of 8 persons (50%) with moderate or severe OSA and in none of 12 persons (0%) with no or mild OSA (p<0.01).
CONCLUSION: Obese persons with moderate or severe OSA have a significantly higher prevalence of moderate or severe LVDD than obese persons with no or mild OSA (p<0.01).
CLINICAL IMPLICATIONS: The higher prevalence of moderate or severe LVDD in obese persons with moderate or severe OSA predisposes them to develop congestive heart failure with a normal left ventricular ejection fraction.
DISCLOSURE: Jasdeep Sidana, None.
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