Subclinical Changes in Cardiac Functional Parameters as Determined by Cardiovascular Magnetic Resonance (CMR) Imaging in Sleep Apnea and Snoring: Findings from UK Biobank
Adrian Curta,
Holger Hetterich,
Regina Schinner,
Aaron M. Lee,
Wieland Sommer,
Nay Aung,
Mihir M. Sanghvi,
Kenneth Fung,
Elena Lukaschuk,
Jackie A. Cooper,
José Miguel Paiva,
Valentina Carapella,
Stefan Neubauer,
Stefan K. Piechnik,
Steffen E. Petersen
Affiliations
Adrian Curta
Clinic of Radiology, Ludwig-Maximilian University Hospital, 81377 Munich, Germany
Holger Hetterich
Clinic of Radiology, Ludwig-Maximilian University Hospital, 81377 Munich, Germany
Regina Schinner
Clinic of Radiology, Ludwig-Maximilian University Hospital, 81377 Munich, Germany
Aaron M. Lee
NIHR Biomedical Research Centre at Barts, William Harvey Research Institute, Queen Mary University of London, London E1 4NS, UK
Wieland Sommer
Clinic of Radiology, Ludwig-Maximilian University Hospital, 81377 Munich, Germany
Nay Aung
NIHR Biomedical Research Centre at Barts, William Harvey Research Institute, Queen Mary University of London, London E1 4NS, UK
Mihir M. Sanghvi
NIHR Biomedical Research Centre at Barts, William Harvey Research Institute, Queen Mary University of London, London E1 4NS, UK
Kenneth Fung
NIHR Biomedical Research Centre at Barts, William Harvey Research Institute, Queen Mary University of London, London E1 4NS, UK
Elena Lukaschuk
Cardiovascular Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
Jackie A. Cooper
NIHR Biomedical Research Centre at Barts, William Harvey Research Institute, Queen Mary University of London, London E1 4NS, UK
José Miguel Paiva
NIHR Biomedical Research Centre at Barts, William Harvey Research Institute, Queen Mary University of London, London E1 4NS, UK
Valentina Carapella
Cardiovascular Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
Stefan Neubauer
Cardiovascular Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
Stefan K. Piechnik
Cardiovascular Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
Steffen E. Petersen
NIHR Biomedical Research Centre at Barts, William Harvey Research Institute, Queen Mary University of London, London E1 4NS, UK
Background and Objectives: Obstructive sleep apnea (OSA) is a common disorder with an increased risk for left ventricular and right ventricular dysfunction. Most studies to date have examined populations with manifest cardiovascular disease using echocardiography to analyze ventricular dysfunction with little or no reference to ventricular volumes or myocardial mass. Our aim was to explore these parameters with cardiac MRI. We hypothesized that there would be stepwise increase in left ventricular mass and right ventricular volumes from the unaffected, to the snoring and the OSA group. Materials and Methods: We analyzed cardiac MRI data from 4978 UK Biobank participants free from cardiovascular disease. Participants were allocated into three cohorts: with OSA, with self-reported snoring and without OSA or snoring (n = 118, 1886 and 2477). We analyzed cardiac parameters from balanced cine-SSFP sequences and indexed them to body surface area. Results: Patients with OSA were mostly males (47.3% vs. 79.7%; p p p = 0.012) compared to individuals without OSA or snoring. Regression analysis showed a significant effect for OSA in left ventricular end-diastolic index (LVEDVI) (β = −4.9 ± 2.4 mL/m²; p = 0.040) and right ventricular end-diastolic index (RVEDVI) (β = −6.2 ± 2.6 mL/m²; p = 0.016) in females and for right ventricular ejection fraction (RVEF) (β = 1.7 ± 0.8%; p = 0.031) in males. A significant effect was discovered in snoring females for left ventricular mass index (LVMI) (β = 3.5 ± 0.9 g/m²; p p = 0.001) and RVEF (β = 1.2 ± 0.3%; p Conclusion: Our study suggests that OSA is highly underdiagnosed and that it is an evolving process with gender specific progression. Females with OSA show significantly lower ventricular volumes while males with snoring show increased ejection fractions which may be an early sign of hypertrophy. Separate prospective studies are needed to further explore the direction of causality.