Obstructive Sleep Apnea is Common and Associated with Heart Remodeling in Patients with Chagas Disease

Chagas Disease (CD) is an important cause of morbimortality due to heart failure and malignant arrhythmias worldwide, especially in Latin America. To investigate the association of obstructive sleep apnea (OSA) with heart remodeling and cardiac arrhythmias in patients CD. Consecutive patients with C...

Full description

Saved in:

Bibliographic Details
Published in:	Arquivos brasileiros de cardiologia 2018-09, Vol.111 (3), p.364-372
Main Authors:	Medeiros, Carolina de Araújo, Secundo, Isaac Vieira, Silveira, Carlos Antônio da Mota, Castilho, José Maria Del, Albuquerque, Afonso Luiz Tavares de, Martins, Sílvia Marinho, Oliveira Júnior, Wilson de, Lorenzi-Filho, Geraldo, Drager, Luciano F, Pedrosa, Rodrigo Pinto
Format:	Article
Language:	eng ; por
Subjects:	Apneia Obstrutiva do Sono Arritmias Cardíacas CARDIAC & CARDIOVASCULAR SYSTEMS Doença de Chagas Original Remodelação Ventricular
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Chagas Disease (CD) is an important cause of morbimortality due to heart failure and malignant arrhythmias worldwide, especially in Latin America. To investigate the association of obstructive sleep apnea (OSA) with heart remodeling and cardiac arrhythmias in patients CD. Consecutive patients with CD, aged between 30 to 65 years old were enrolled. Participants underwent clinical evaluation, sleep study, 24-hour Holter monitoring, echocardiogram and ambulatory blood pressure monitoring. We evaluated 135 patients [age: 56 (45-62) years; 30% men; BMI: 26 ± 4 kg/m2, Chagas cardiomyopathy: 70%]. Moderate to severe OSA (apnea-hypopnea index, AHI, ≥ 15 events/h) was present in 21% of the patients. OSA was not associated with arrhythmias in this population. As compared to patients with mild or no OSA, patients with moderate to severe OSA had higher frequency of hypertension (79% vs. 72% vs. 44%, p < 0.01) higher nocturnal systolic blood pressure: 119 ± 17 vs. 113 ± 13 vs. 110 ± 11 mmHg, p = 0.01; larger left atrial diameter [37 (33-42) vs. 35 (33-39) vs. 33 (30-36) mm, p < 0.01]; and a greater proportion of left ventricular dysfunction [LVEF < 50% (39% vs. 28% vs. 11%), p < 0.01], respectively. Predictor of left atrial dimension was Log10 (AHI) (b = 3.86, 95% CI: 1.91 to 5.81; p < 0.01). Predictors of ventricular dysfunction were AHI > 15 events/h (OR = 3.61, 95% CI: 1.31 - 9.98; p = 0.01), systolic blood pressure (OR = 1.06, 95% CI: 1.02 - 1.10; p < 0.01) and male gender (OR = 3.24, 95% CI: 1.31 - 8.01; p = 0.01). OSA is independently associated with atrial and ventricular remodeling in patients with CD.
ISSN:	0066-782X 1678-4170 1678-4170