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[Structural cardiac changes in patients with obstructive sleep apnea]

B Sanner1, M Konermann, A Sturm

  • 1Medizinische Universitätsklinik der Ruhr-Universität Bochum Marienhospital I, Herne.

Zeitschrift Fur Kardiologie
|May 1, 1995
PubMed
Summary
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[Guidelines in Practice: The New S3 Guideline "Sleeping Disorders - Sleep-Related Abnormal Breathing"].

Pneumologie (Stuttgart, Germany)·2017

Obstructive sleep apnea causes significant cardiovascular strain through hypoxia and sleep fragmentation, leading to characteristic cardiac structural changes like ventricular and atrial dilation and hypertrophy, defining the "sleep apnea heart".

Area of Science:

  • Cardiology
  • Sleep Medicine
  • Pathophysiology

Context:

  • Obstructive sleep apnea (OSA) is a common sleep disorder characterized by repeated upper airway collapse during sleep.
  • OSA leads to intermittent hypoxia, hypercapnia, and sleep fragmentation, triggering significant physiological stress.
  • These stressors impact the cardiovascular system, initially during sleep and progressively during wakefulness.

Purpose:

  • To elucidate the pathophysiological mechanisms linking obstructive sleep apnea to cardiac structural alterations.
  • To identify specific cardiac changes that characterize the condition, potentially defining a "sleep apnea heart".

Summary:

  • Key OSA mechanisms include increased pleural pressure swings, hypoxia, hypercapnia, and central nervous arousals.
  • These factors disrupt sleep architecture and profoundly affect cardiovascular function.

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  • Progressive cardiac remodeling in OSA involves right and left ventricular dilation and hypertrophy, as well as atrial dilation, particularly affecting the ventricular septum.

    • Impact:

    • The identified cardiac structural changes may serve as diagnostic markers for OSA.
    • Understanding these changes contributes to the concept of a distinct "sleep apnea heart" phenotype.
    • This research highlights the critical link between sleep-disordered breathing and cardiovascular pathology.