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Prevalencia e implicaciones clínicas de la apnea del sueño en la miocardiopatía hipertrófica
Shahid Karim1,2, Anwar Chahal1,2,3,4, Shreyas Venkataraman5
1Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
JAMA cardiology
|September 3, 2025
Resumen
Los trastornos respiratorios del sueño son comunes en pacientes con cardiomiopatía hipertrófica (HCM), vinculados a una peor remodelación del corazón y a un aumento de la troponina-T. El tratamiento de SDB puede mejorar los resultados de la CMH.
Área de la Ciencia:
- Cardiología
- Medicina del sueño
- La genética
Sus antecedentes:
- Los trastornos respiratorios del sueño contribuyen a las enfermedades cardiovasculares a través de la hipoxemia y la disfunción autónoma.
- Los pacientes con cardiomiopatía hipertrófica (HCM) pueden tener un mayor riesgo de SDB, pero su impacto no está claro.
Objetivo del estudio:
- Determinar la prevalencia de SDB en pacientes con HCM.
- Investigar la asociación entre el SDB, los hallazgos ecocardiográficos y los biomarcadores cardíacos en la CMH.
Principales métodos:
- Estudio de cohorte prospectivo de 154 pacientes adultos con CMH.
- La polisomnografía se utiliza para diagnosticar y clasificar el SDB.
- Se evaluaron la ecocardiografía, el ECG y los biomarcadores cardíacos, con ceguera a los resultados del SDB.
Principales resultados:
- SDB fue diagnosticado en el 59,1% de los pacientes con CMH.
- SDB asociado con índice de masa ventricular izquierda más alto, relación E/e' y niveles de troponina-T.
- Los síntomas de clase II/III de la NYHA, la hipertensión y la diabetes fueron más comunes en los pacientes con SDB.
Conclusiones:
- El SDB no diagnosticado es muy frecuente en la CMH.
- SDB está relacionado con remodelación miocárdica adversa, disfunción diastólica y lesión subclínica.
- Se requieren ensayos adicionales sobre el tratamiento con SDB en la CMH.
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