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

Carolina de Araújo Medeiros1,2, Isaac Vieira Secundo1, Carlos Antônio da Mota Silveira1

  • 1Laboratório do Sono e Coração do Pronto Socorro Cardiológico de Pernambuco (PROCAPE) da Universidade de Pernambuco, Recife, PE - Brazil.

Arquivos Brasileiros De Cardiologia
|August 9, 2018
PubMed

Insights

Obstructive sleep apnea (OSA) is linked to heart remodeling in Chagas Disease (CD) patients, increasing hypertension and left heart chamber enlargement. This study highlights OSA

Area of Science:

  • Cardiology
  • Sleep Medicine
  • Infectious Diseases

Background:

  • Chagas Disease (CD) is a significant cause of heart failure and arrhythmias globally, particularly in Latin America.
  • Understanding comorbidities like obstructive sleep apnea (OSA) is crucial for managing CD-related cardiovascular risks.

Purpose of the Study:

  • To investigate the association between obstructive sleep apnea (OSA) and cardiac remodeling and arrhythmias in patients with Chagas Disease.
  • To identify predictors of cardiac structural changes in this patient population.

Main Methods:

  • 135 Chagas Disease patients (30-65 years) underwent clinical evaluation, sleep studies, 24-hour Holter monitoring, echocardiograms, and ambulatory blood pressure monitoring.
  • Patients were assessed for the presence and severity of OSA using the apnea-hypopnea index (AHI).
  • Cardiac structure and function were evaluated using echocardiography, focusing on left atrial and ventricular dimensions and function.

Main Results:

  • Moderate to severe OSA (AHI ≥ 15 events/h) was found in 21% of CD patients.
  • OSA was not associated with arrhythmias but was significantly linked to higher rates of hypertension, elevated nocturnal systolic blood pressure, and increased left atrial diameter.
  • Patients with moderate to severe OSA showed a greater proportion of left ventricular dysfunction (LVEF < 50%).
  • Higher AHI predicted larger left atrial dimensions, while AHI > 15 events/h, systolic blood pressure, and male gender predicted ventricular dysfunction.

Conclusions:

  • Obstructive sleep apnea is independently associated with atrial and ventricular remodeling in patients with Chagas Disease.
  • OSA contributes to adverse cardiac structural changes, independent of arrhythmias, in the CD population.
Abstract

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