Impact of obstructive sleep apnea on diastolic function

The association of obstructive sleep apnea (OSA) with diastolic dysfunction is unclear. We investigated whether OSA independently affects diastolic function in a primary care cohort of patients with cardiovascular risk factors. 378 study participants with risk factors for diastolic dysfunction (e. g. hypertension, diabetes, heart failure) from the germanwide DIAST-CHF cohort were prospectively included into this substudy and a polygraphy was performed in all patients. Diastolic dysfunction was assessed by comprehensive echocardiography including tissue Doppler. Patients with more episodes of central sleep apnea than obstructive sleep apnea were excluded from further analysis (n=14). In the remaining subjects, 22.8% had an AHI > 15/h. The prevalence of diastolic dysfunction increased from 75.0% (none) to 81.8% (mild) to 90.2% (severe sleep apnea), p=0.020. The degree of diastolic dysfunction also increased with sleep apnea severity. In univariate regression analysis, age, AHI > 15, heart rate, body mass index, systolic blood pressure and left ventricular mass were associated with diastolic dysfunction. In multivariate regression analysis, only age, AHI > 15 and heart rate were independently associated with diastolic dysfunction. In conclusion OSA is independently associated with diastolic dysfunction in patients with risk factors for diastolic dysfunction. This work was supported by grants from the German Federal Ministry of Education and Research (German Heart Failure Network, TP 7 (FKZ 01GI0205) and clinical trial program Aldo-DHF (FKZ 01KG0506)).