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Vol. 44. Issue 8.
Pages 418-423 (January 2008)
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Vol. 44. Issue 8.
Pages 418-423 (January 2008)
Original Article
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Silent Heart Disease in Patients With Sleep Apnea-Hypopnea Syndrome: Usefulness of the Myocardial Performance Index
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José A. Moroa,b,
Corresponding author
moro@uv.es

Correspondence: Dr J. A. Moro Enebro, 4, puerta 5 46980 Paterna, Valencia, Spain
, Luis Almenarb, Estrella Fernández-Fabrellasc, Silvia Poncec, Rafael Blanquerc, Antonio Salvadorb
a Fundación para la Investigación, Hospital Universitario La Fe, Valencia, Spain
b Unidad de Insuficiencia Cardíaca y Trasplante, Servicio de Cardiología, Hospital Universitario La Fe, Valencia, Spain
c Servicio de Neumología, Hospital Universitario Dr. Peset, Valencia, Spain
Article information
Objective

Sleep apnea-hypopnea syndrome (SAHS) is an emerging disease with considerable cardiovascular impact. The myocardial performance index (MPI) is an echocardiographic parameter that is useful in the assessment of global myocardial function. The purpose of this study was to identify any differences in the MPI between patients with and without SAHS.

Patients and methods

We studied 120 consecutive patients referred to our department for suspected SAHS. Following the overnight sleep study and after excluding all patients with hypertension, heart disease, or invalid recordings, 54 patients with SAHS and 13 patients without the disease matched for age and body mass were analyzed. A blinded cardiologist performed Doppler echocardiography, measuring parameters related to ventricular hypertrophy, systolic function, diastolic function, and the MPI. The data were compared by χ2 and analysis of variance.

Results

Mean (SD) ventricular mass was greater in patients with SAHS (183.17 [40.5] g) than in those without that diagnosis (149 [26] g) (P=.005). No differences were observed in systolic function (78.5% [8.95%] vs 81.6% [7%]) (P=.2), although a higher percentage of patients with SAHS had abnormal diastolic function (71.2% vs 38.5%) (P=.049). The MPI was significantly higher in SAHS patients (0.54 [0.12] vs 0.46 [0.07]) (P=.028).

Conclusions

On its own, SAHS leads to left ventricular hypertrophy. Diastolic involvement is common in these patients, although a large number of healthy individuals who are obese also present it. The MPI is higher in SAHS and could be a useful parameter to identify patients with silent heart disease before it progresses.

Key words:
Sleep apnea−hypopnea syndrome
Doppler echocardiography
Hypertrophy
Left ventricular dysfunction
Objetivo

El síndrome de apneas-hipopneas durante el sueño (SAHS) es una enfermedad emergente con importante repercusión cardiovascular. El índice de rendimiento miocárdico (IRM) es un parámetro ecocardiográfico útil en la valoración de la función miocárdica global. El objetivo del estudio ha sido analizar si hay diferencias en el IRM entre pacientes con SAHS y un grupo control.

Pacientes y métodos

Hemos estudiado a 120 pacientes consecutivos remitidos por sospecha de SAHS a nuestra unidad. Una vez realizado el estudio nocturno y excluidos los hipertensos, cardiópatas o registros inadecuados, analizamos a 54 pacientes y 13 controles de similar edad e índice de masa corporal. Un cardiólogo que desconocía la asignación les realizó un ecocardiograma Doppler. Se midieron parámetros de hipertrofia ventricular, función sistólica, función diastólica y el IRM. Los datos se compararon mediante el test de la χ2 y ANOVA.

Resultados

Los pacientes con SAHS presentaron mayor masa ventricular que el grupo control (media ± desviación estándar: 183,17 ± 40,5 frente a 149 ± 26 g; p = 0,005). No se apreciaron diferencias entre ambos grupos en la función sistólica (un 78,5 ± 8,95 frente al 81,6 ± 7%; p = 0,2), pero un mayor porcentaje de pacientes con SAHS tenía alterada la función diastólica (un 71,2 frente al 38,5%; p = 0,049). El IRM fue significativamente mayor en el grupo con SAHS (0,54 ± 0,12 frente a 0,46 ± 0,07; p = 0,028).

Conclusiones

El SAHS por sí mismo produce hipertrofia ventricular izquierda. La afectación diastólica es importante en este grupo, pero también la presenta un número importante de personas sanas con obesidad. El IRM está incrementado en el SAHS y podría ser útil para identificar a los pacientes con disfunción miocárdica silente antes de su progresión.

Palabras clave:
Síndrome de apneas-hipopneas durante el sueño
Ecocardiografía Doppler
Hipertrofia
Disfunción ventricular izquierda
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Copyright © 2008. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
Archivos de Bronconeumología

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