RSTRUCTURAL AND FUNCTIONAL FEATURES OF THE HEART IN PATIENTS WITH OBSTRUCTIVE SLEEP APNOEA SYNDROME DEPENDING ON ITS SEVERITY AND THE MAGNITUDE OF METABOLIC SYNDROME
https://doi.org/10.17650/1818-8338-2011-1-28-32
Abstract
Objective: to assess the nature and degree of the impact of metabolic syndrome (MS) and obstructive sleep apnoea syndrome (OSAS) severity on myocardial structural and functional changes.
Subjects and methods. The study covered 80 patients of both sexes, whose mean age was 49.62 ± 9.87 years. The patients were divided into 3 groups according to the severity of OSAS. All the patients underwent general clinical examination with anthropometric measurements, as well as cardiorespiratory monitoring and biochemical studies.
Results. The mean body mass index in the examinees was 34.52 ± 4.91 kg/m2. In severe apnoea, there was a significant increase in abdominal adipose tissue redistribution (p = 0.005), an elevation in systolic and diastolic blood pressures and uric acid levels, progression of impaired lipid profile and insulin resistance (p < 0.05). More significant hypertrophy of the left ventricle and its reduced systolic function were recorded in severe OSAS (р < 0.05). The frequency of type 1 diastolic dysfunction was lower in the mild apnoea group (30% of the patients) than that in the severe apnoea group (67 %) (p = 0.01).
Conclusion. The found myocardial structural and functional changes are due to the degree of OSAS and to the impact of MS components. Due to inadequately effective antihypertensive and hypolipidemic therapy performed in patients with MS, it is necessary to diagnose OSAS and to define the degree of its severity for its correction.
About the Authors
V. V. Shchekotov
Acad. E.A. Vagner Perm State Medical Academy
Russian Federation
Russian Federation
T. I. Yankina
Acad. E.A. Vagner Perm State Medical Academy
Russian Federation
Russian Federation
E. V. Zhizhilev
Acad. E.A. Vagner Perm State Medical Academy
Russian Federation
Russian Federation
References
1. Белов А.М., Захаров В.Н., Горенкова М.Н., Воронин И.М. Обструктивные нарушения дыхания во время сна и нарушения сердечного ритма. Терапевтический архив 2004;76(3):55–9.
2. Ерошина В.А., Бузунов Р.В. Храп и синдром обструктивного апноэ сна. М., 2004.
3. Doherty J.U., Liang C.S. Arterial hypoxemia in awake dogs. Role of the sympathetic nervous system in mediating the systemic hemodynamic and regional blood flow responses. Lab Clin Med
4. ;104:665–77.
5. Всероссийское научное общество кардиологов. Рекомендации экспертов всероссийского научного общества кардиологов по диагностике и лечению метаболического синдрома (2-й пересмотр). М., 2009.
6. Devereux R., Reichek N. Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method. Circulation 1977;55:613–8.
7. Ganau A., Devereux R.B., Roman M.J., et el. Patterns of left ventricular hypertrophy and geometric remodeling in essential hypertension. J Am Coll Cardiol 1992;19(7):1550–8.
8. Hosselet J., Ayappa I., Norman R.G., et al. Classification of sleep-disordered breathing. Am J Respir Crit Care Med 2001;163:398–405.
9. Patel M.B., Stewart J.M., Loud A.V., et al. Altered function and structure of the heart in dogs with chronic elevation in plasma norepinephrine. Circulation 1991;84(5):2091–100.
10. Kuch B., Hense H.W., Gneiting В., et al. Body composition and prevalence of left ventricular hypertrophy. Circulation 2000;102(4):405–10.
11. Brands M.W., Fitzgerald S.M. Blood pressure control early in diabetes: a balance between angiotensin II and nitric oxide. Clin Exp Pharmacol Physiol 2002;29(1–2):127–31.
12. Aurigemma G.P., Silver К.Н., Priest M.A., Gaasch W.H. Geometric changes allow normal ejection fraction despite depressed myocardial shortening in hypertensive left ventricular hypertrophy.
13. J Am Coll Cardiol 1995;26(1):195–202.
14. Нedner J., Ejnell H., Caidahl K. Left ventricular hypertrophy independent of hypertension in patients with obstructive sleep apnoea. J Hypertens 1990;8:941–6.
15. Ротарь О.П., Свиряев Ю.В., Звартау Н.Э. и др. Поражение органов-мишеней у больных с артериальной гипертензией с синдромом обструктивного апноэ/гипопноэ во сне. Бюллетень научно-исследовательского института кардиологии им. В.А. Алмазова 2005;1:7.
Review
For citations:
Shchekotov V.V., Yankina T.I., Zhizhilev E.V. RSTRUCTURAL AND FUNCTIONAL FEATURES OF THE HEART IN PATIENTS WITH OBSTRUCTIVE SLEEP APNOEA SYNDROME DEPENDING ON ITS SEVERITY AND THE MAGNITUDE OF METABOLIC SYNDROME. The Clinician. 2011;5(1):28-32. (In Russ.) https://doi.org/10.17650/1818-8338-2011-1-28-32
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