Chest ACCP Career Connection
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
doi:10.1378/chest.06-2444
(Chest. 2007; 131:1082-1089)
© 2007 American College of Chest Physicians
This Article
Right arrow Full Text Free
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via ISI Web of Science (1)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Okuda, N.
Right arrow Articles by Kitaura, Y.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Okuda, N.
Right arrow Articles by Kitaura, Y.

Depressed Myocardial Contractile Reserve in Patients With Obstructive Sleep Apnea Assessed by Tissue Doppler Imaging With Dobutamine Stress Echocardiography*

Nobuaki Okuda, MD; Takahide Ito, MD, PhD; Narutsugu Emura, MD, PhD; Michihiro Suwa, MD, PhD; Tetsuya Hayashi, MD, PhD; Hiroshi Yoneda, MD, PhD and Yasushi Kitaura, MD, PhD

* From the Third Department of Internal Medicine (Drs. Okuda, Ito, Suwa, Hayashi, and Kitaura) and Department of Neuropsychiatry (Drs. Emura and Yoneda), Osaka Medical College, Takatsuki, Japan.

Correspondence to: Takahide Ito, MD, PhD, Third Department of Internal Medicine, Osaka Medical College, 2–7, Daigaku-cho, Takatsuki City, Osaka, 569-8686, Japan; e-mail: in3016{at}poh.osaka-med.ac.jp

Abstract

Background: Hypoxia has been suggested to affect myocardial contractile function in patients with obstructive sleep apnea (OSA). We sought to determine whether myocardial contractile reserve (MCR), as evaluated by echocardiographic tissue Doppler imaging with dobutamine stress (TDDS), might be depressed in OSA patients.

Methods: Thirty patients with suspected OSA (25 men and 5 women; mean age, 51 ± 11 years [± SD]) underwent overnight polysomnography and TDDS. Peak myocardial systolic velocity (Sm) and peak myocardial early diastolic velocity (Em) in the 12 myocardial segments of the left ventricular (LV) walls were averaged, and the mean Sm and Em during TDDS were compared between patients with apnea-hypopnea index (AHI) <15/h (group 1, n = 13) and those with AHI ≥ 15/h (group 2, n = 17). MCR was calculated as the difference between the resting and peak Sm during TDDS.

Results: In both groups, Sm increased dose dependently during TDDS. However, the relative increase in Sm was significantly lower in group 2, resulting in a lower value of MCR (5.5 ± 1.2 cm/s vs 7.4 ± 1.3 cm/s, p < 0.001). The Em was lower in group 2 compared with group 1 throughout TDDS. MCR was correlated significantly with AHI (r = – 0.67, p < 0.0001), resting Em (r = 0.53, p < 0.005), and body mass index (r = – 0.46, p < 0.05) independent of the LV mass index.

Conclusions: OSA can affect MCR, implying an etiologic contribution from repetitive hypoxic events. TDDS could identify subtle abnormalities of OSA-related cardiac involvement.

Key Words: contractile reserve • Doppler ultrasound • obstructive sleep apnea • stress echocardiography






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2007 by the American College of Chest Physicians.