0
Original Research: SLEEP MEDICINE |

Depressed Myocardial Contractile Reserve in Patients With Obstructive Sleep Apnea Assessed by Tissue Doppler Imaging With Dobutamine Stress Echocardiography*

Nobuaki Okuda, MD; Takahide Ito, MD, PhD; Narutsugu Emura, MD, PhD; Michihiro Suwa, MD, PhD; Tetsuya Hayashi, MD, PhD; Hiroshi Yoneda, MD, PhD; Yasushi Kitaura, MD, PhD
Author and Funding Information

*From the Third Department of Internal Medicine (Drs. Okuda, Ito, Suwa, Hayashi, and Kitaura) and Department of Neuropsychiatry (Drs. Emura and Yoneda), Osaka Medical College, Takatsuki, Japan.

Correspondence to: Takahide Ito, MD, PhD, Third Department of Internal Medicine, Osaka Medical College, 2–7, Daigaku-cho, Takatsuki City, Osaka, 569-8686, Japan; e-mail: in3016@poh.osaka-med.ac.jp



Chest. 2007;131(4):1082-1089. doi:10.1378/chest.06-2444
Text Size: A A A
Published online

Background: Hypoxia has been suggested to affect myocardial contractile function in patients with obstructive sleep apnea (OSA). We sought to determine whether myocardial contractile reserve (MCR), as evaluated by echocardiographic tissue Doppler imaging with dobutamine stress (TDDS), might be depressed in OSA patients.

Methods: Thirty patients with suspected OSA (25 men and 5 women; mean age, 51 ± 11 years [± SD]) underwent overnight polysomnography and TDDS. Peak myocardial systolic velocity (Sm) and peak myocardial early diastolic velocity (Em) in the 12 myocardial segments of the left ventricular (LV) walls were averaged, and the mean Sm and Em during TDDS were compared between patients with apnea-hypopnea index (AHI) <15/h (group 1, n = 13) and those with AHI ≥ 15/h (group 2, n = 17). MCR was calculated as the difference between the resting and peak Sm during TDDS.

Results: In both groups, Sm increased dose dependently during TDDS. However, the relative increase in Sm was significantly lower in group 2, resulting in a lower value of MCR (5.5 ± 1.2 cm/s vs 7.4 ± 1.3 cm/s, p < 0.001). The Em was lower in group 2 compared with group 1 throughout TDDS. MCR was correlated significantly with AHI (r = − 0.67, p < 0.0001), resting Em (r = 0.53, p < 0.005), and body mass index (r = − 0.46, p < 0.05) independent of the LV mass index.

Conclusions: OSA can affect MCR, implying an etiologic contribution from repetitive hypoxic events. TDDS could identify subtle abnormalities of OSA-related cardiac involvement.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

CHEST Journal Articles
Guidelines
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543