Journal Club - Obstructive sleep apnea, obesity to cause heart insufficiency

There has always been a linear correlation between obesity and OSA. how? the theory behind this is that in obese people, fat deposits in the upper respiratory tract narrow the airway; there is a decrease in muscle activity in this region, leading to hypoxic and apneic episodes, ultimately resulting in sleep apnea.

 obstructive sleep apnea and obesity as combination causes myocardial remodeling and cardiac health issues. Assessment of cardiac function during the early stages of cardiac insufficiency in obese obstructive sleep apnea patients has not yet been reported but with intervention could potentially help in reducing cardiovascular morbidity and mortality.

Early impairment of cardiac function in obesity or obstructive sleep apnea, such as changes regional contractile strain, may be subtle and therefore challenging to detect on routine echocardiography.

The observational study, compared 79 patients with mild to severe obstructive sleep apnea who were either obese (n = 33) or nonobese (n = 46) with 20 non obese control subjects in whom obstructive sleep apnea was not observed at sleep monitoring.

Fasting blood glucose, glycosylated hemaglobin (HgA1C) levels, and BMI were significantly higher in the obstructive sleep apnea group than the control group (P < .05).

Researchers concluded that impaired left ventricular (LV) myocardial strain observed in patients with obstructive sleep apnea (OSA) points to subclinical LV systolic dysfunction, which was more pronounced in those who were also obese. Superimposed conditions such as hypoxia and insulin resistance are associated with more severe cardiac functional impairment in patients with both obstructive sleep apnea  and obesity.