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Left ventricular hypertrophy and abnormal ventricular geometry in children and adolescents with obstructive sleep
Raouf S Amin1, Thomas R Kimball, Judy A Bean
1Department of Pulmonary Medicine, Allergy & Clinical Immunology, Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA. aminr0@chmcc.org
Insights
Obstructive sleep apnea (OSA) in children is linked to significant heart changes. Children with OSA show increased left ventricular mass and abnormal heart geometry compared to those with primary snoring.
Area of Science:
- Pediatric Cardiology
- Sleep Medicine
- Cardiovascular Research
Background:
- Obstructive sleep apnea (OSA) is an independent cardiovascular disease risk factor in adults.
- Cardiovascular consequences of pediatric OSA are understudied.
- Limited research exists on echocardiographic changes in children with OSA.
Purpose of the Study:
- To investigate echocardiographic changes in children with obstructive sleep apnea.
- To compare cardiac dimensions and mass between children with OSA and primary snoring (PS).
- To identify associations between OSA severity and cardiac abnormalities.
Main Methods:
- Echocardiographic measurements of right and left ventricular (RV, LV) dimensions, LV mass index, and geometry.
- Study included 28 children with OSA and 19 children with PS.
- Apnea-hypopnea index (AHI) was correlated with cardiac parameters.
Main Results:
- Children with OSA had significantly greater LV mass index and relative wall thickness than those with PS.
- An AHI > 10/hour was associated with increased RV dimension and LV mass index.
- Abnormal LV geometry was more prevalent in children with OSA (39%) compared to PS (15%).
Conclusions:
- Pediatric obstructive sleep apnea is associated with increased left ventricular mass.
- OSA in children is linked to cardiac structural changes.
- Early identification and management of OSA may be crucial for pediatric cardiovascular health.
Abstract:
Obstructive sleep apnea (OSA) has been shown to be an independent risk factor for cardiovascular disease in adults. However, there are severe limitations in the extent to which the cardiovascular consequences of OSA are being studied in children. To investigate the echocardiographic changes in children with OSA, right and left ventricular (RV, LV) dimensions and LV mass index and geometry were measured in 28 children with OSA and 19 children with primary snoring (PS). The study showed that LV mass index and relative wall thickness were greater in the OSA group compared with those with PS (p = 0.012 and p < 0.0001, respectively). An apnea-hypopnea index of more than 10 per hour was significantly associated with RV dimension above the 95th percentile (odds ratios, 6.7; 95% confidence interval, 1.4-32) and LV mass index above the 95th percentile (odds ratios, 11.2; confidence interval, 1.9-64). Abnormality of LV geometry was present in 15% of children with PS compared with 39% of children with OSA. We conclude that OSA in children is associated with increased LV mass.