To investigate the prevalence of moderate or severe left ventricular diastolic dysfunction (LVDD) in obese persons with moderate or severe obstructive sleep apnea (OSA).
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.
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).
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).
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.
Jasdeep Sidana, None.