Association Between Sleep Disordered Breathing and Left Ventricular Function: A Cross-Sectional Analysis of the ECHO-SOL Ancillary Study.
Association Between Sleep Disordered Breathing and Left Ventricular Function: A Cross-Sectional Analysis of the ECHO-SOL Ancillary Study.
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DOI：
10.1161/circimaging.119.009074
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发表时间：
2020-05
期刊：
影响因子：
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通讯作者：
Rodriguez CJ
中科院分区：
文献类型：
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作者：
Ogilvie RP;Genuardi MV;Magnani JW;Redline S;Daviglus ML;Shah N;Kansal M;Cai J;Ramos AR;Hurwitz BE;Ponce S;Patel SR;Rodriguez CJ
先前的研究发现，睡眠呼吸障碍（SDB）在左心室功能障碍和心力衰竭患者中很常见。很少有流行病学研究考察这种关联，特别是在美国的西班牙裔/拉丁裔人群中，他们患SDB和心力衰竭的风险可能较高。我们使用西班牙社区健康研究/拉丁裔ECHO-SOL辅助研究（2011-2014）中1506名18-64岁成年人的数据，研究了SDB与左室舒张和收缩功能之间的关系。采用家庭睡眠测试测量呼吸暂停低通气指数（AHI），这是SDB严重程度的衡量指标。平均2.1年后进行超声心动图，量化左室舒张功能、收缩功能和结构。考虑到复杂的调查设计、人口统计、体重和睡眠与超声心动图测量之间的时间间隔，采用多变量线性回归对AHI与超声心动图测量之间的关系进行建模。AHI每增加10个单位，E′值降低0.2 (95% CI 0.1, 0.3)， E/E′值升高0.3(0.1,0.5)，舒张功能不全发生率升高1.07倍（1.03,1.11），左室质量指数升高1.3 (0.3,2.4)g/m2。在调整高血压和糖尿病后，这些关联仍然存在。相反，未发现SDB严重程度与左室收缩功能的亚临床指标之间存在关联。更严重的SDB与左室肥厚和左室舒张功能障碍的亚临床指标相关。这些发现表明，西班牙裔/拉丁裔男性和女性的SDB可能会导致该人群的心力衰竭负担。
Prior studies have found that sleep-disordered breathing (SDB) is common among those with left ventricular (LV) dysfunction and heart failure. Few epidemiological studies have examined this association, especially in U.S. Hispanic/Latinos, who may be at elevated risk of SDB and heart failure. We examined associations between SDB and LV diastolic and systolic function using data from 1,506 adults aged 18–64 years in the Hispanic Community Health Study/Study of Latinos ECHO-SOL Ancillary Study (2011–2014). Home sleep testing was used to measure the apnea-hypopnea index (AHI), a measure of SDB severity. Echocardiography was performed a median of 2.1 years later to quantify LV diastolic function, systolic function, and structure. Multivariable linear regression was used to model the association between AHI and echocardiographic measures while accounting for the complex survey design, demographics, body mass and time between sleep and echocardiographic measurements. Each 10-unit increase in AHI was associated with 0.2 (95% CI 0.1, 0.3) lower E’, 0.3 (0.1, 0.5) greater E/E’ ratio, and 1.07-fold (1.03, 1.11) higher prevalence of diastolic dysfunction as well as 1.3 (0.3, 2.4) g/m2 greater LV mass index. These associations persisted after adjustment for hypertension and diabetes. In contrast, no association was identified between SDB severity and subclinical markers of LV systolic function. Greater SDB severity was associated with LV hypertrophy and subclinical markers of LV diastolic dysfunction. These findings suggest SDB in Hispanic/Latino men and women may contribute to the burden of heart failure in this population.