Association Between Central Sleep Apnea and Left Atrial Enlargement in Snoring Patients with Preserved Ejection Fraction

Xinghe Sun,1,* Yang Wang,1,* Chaoqun Wu,2,3 Yinghui Gao4 1Department of Cardiology, Peking University International Hospital, Beijing, People’s Republic of China; 2National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hosp...

Full description

Saved in:
Bibliographic Details
Main Authors: Sun X, Wang Y, Wu C, Gao Y
Format: Article
Language:English
Published: Dove Medical Press 2025-03-01
Series:Nature and Science of Sleep
Subjects:
Online Access:https://www.dovepress.com/association-between-central-sleep-apnea-and-left-atrial-enlargement-in-peer-reviewed-fulltext-article-NSS
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850227229941825536
author Sun X
Wang Y
Wu C
Gao Y
author_facet Sun X
Wang Y
Wu C
Gao Y
author_sort Sun X
collection DOAJ
description Xinghe Sun,1,&ast; Yang Wang,1,&ast; Chaoqun Wu,2,3 Yinghui Gao4 1Department of Cardiology, Peking University International Hospital, Beijing, People’s Republic of China; 2National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China; 3Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, People’s Republic of China; 4Department of Sleep Medicine, Peking University International Hospital, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Chaoqun Wu, National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China, Email wuchaoqun@fuwai.com Yinghui Gao, Department of Sleep Medicine, Peking University International Hospital, Life Park Road No.1 Life Science Park of Zhong Guancun, Beijing, People’s Republic of China, Email gaoyinghui1@pkuih.edu.cnBackground: Central sleep apnea (CSA) significantly impacts cardiovascular health, linking it to left atrial enlargement, atrial fibrillation, and impaired cardiac function in heart failure patients with reduced ejection fraction (EF). However, the relationship between CSA and left atrial size in individuals with preserved EF remains underexplored.Objective: This study aims to examine the relationship between left atrial size and CSA in snoring patients with preserved EF.Methods: An observational study was conducted involving 341 consecutive snoring patients from a cardiology department who underwent overnight polysomnography (PSG) and echocardiography. Patients with EF below 50%, pulmonary diseases or neuromuscular disorders were excluded. CSA was defined as a central apnea-hypopnea index (CAHI) of five or more events per hour. Inverse probability of treatment weighting (IPTW) and logistic regression models were employed to evaluate the relationship between CSA and left atrial size.Results: Among the 341 patients, 33 (9.68%) were diagnosed with CSA, with a higher prevalence in males (10.0%) than females (8.91%). Left atrial enlargement (LAE) was observed in 172 patients (50.44%), predominantly in females (71.29%). CSA patients demonstrated significantly higher apnea-hypopnea index (AHI) (49.2/h vs 26.75/h, p < 0.01) and oxygen desaturation index (ODI) (44.9 vs 22.85, p < 0.01), alongside more sleep time with oxygen saturation < 90% (6.6% vs 2.35%, p = 0.01). Echocardiographic evaluations revealed that CSA patients had a greater left atrial anterior-posterior diameter(LAD-ap 42.73 ± 13.01 mm vs 38.15 ± 4.58 mm, p < 0.01) and a higher frequency of LAE (69.7% vs 48.38%, p = 0.02). Males with CSA had a significantly increased risk of LAE (OR: 4.54; 95% CI: 1.45– 14.2) after IPTW adjustment, with significant associations persisting among those with risk factors such as smoking and dyslipidemia.Conclusion: This study highlights a significant association between CSA and left atrial enlargement in males with preserved EF, suggesting that CSA may contribute to atrial remodeling even without reduced ejection fraction.Keywords: central sleep apnea, left atrial enlargement, preserved ejection fraction
format Article
id doaj-art-544ca107d85d49aebe687e8600ee8a6c
institution OA Journals
issn 1179-1608
language English
publishDate 2025-03-01
publisher Dove Medical Press
record_format Article
series Nature and Science of Sleep
spelling doaj-art-544ca107d85d49aebe687e8600ee8a6c2025-08-20T02:04:54ZengDove Medical PressNature and Science of Sleep1179-16082025-03-01Volume 17447460101084Association Between Central Sleep Apnea and Left Atrial Enlargement in Snoring Patients with Preserved Ejection FractionSun XWang YWu CGao YXinghe Sun,1,&ast; Yang Wang,1,&ast; Chaoqun Wu,2,3 Yinghui Gao4 1Department of Cardiology, Peking University International Hospital, Beijing, People’s Republic of China; 2National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China; 3Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, People’s Republic of China; 4Department of Sleep Medicine, Peking University International Hospital, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Chaoqun Wu, National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China, Email wuchaoqun@fuwai.com Yinghui Gao, Department of Sleep Medicine, Peking University International Hospital, Life Park Road No.1 Life Science Park of Zhong Guancun, Beijing, People’s Republic of China, Email gaoyinghui1@pkuih.edu.cnBackground: Central sleep apnea (CSA) significantly impacts cardiovascular health, linking it to left atrial enlargement, atrial fibrillation, and impaired cardiac function in heart failure patients with reduced ejection fraction (EF). However, the relationship between CSA and left atrial size in individuals with preserved EF remains underexplored.Objective: This study aims to examine the relationship between left atrial size and CSA in snoring patients with preserved EF.Methods: An observational study was conducted involving 341 consecutive snoring patients from a cardiology department who underwent overnight polysomnography (PSG) and echocardiography. Patients with EF below 50%, pulmonary diseases or neuromuscular disorders were excluded. CSA was defined as a central apnea-hypopnea index (CAHI) of five or more events per hour. Inverse probability of treatment weighting (IPTW) and logistic regression models were employed to evaluate the relationship between CSA and left atrial size.Results: Among the 341 patients, 33 (9.68%) were diagnosed with CSA, with a higher prevalence in males (10.0%) than females (8.91%). Left atrial enlargement (LAE) was observed in 172 patients (50.44%), predominantly in females (71.29%). CSA patients demonstrated significantly higher apnea-hypopnea index (AHI) (49.2/h vs 26.75/h, p < 0.01) and oxygen desaturation index (ODI) (44.9 vs 22.85, p < 0.01), alongside more sleep time with oxygen saturation < 90% (6.6% vs 2.35%, p = 0.01). Echocardiographic evaluations revealed that CSA patients had a greater left atrial anterior-posterior diameter(LAD-ap 42.73 ± 13.01 mm vs 38.15 ± 4.58 mm, p < 0.01) and a higher frequency of LAE (69.7% vs 48.38%, p = 0.02). Males with CSA had a significantly increased risk of LAE (OR: 4.54; 95% CI: 1.45– 14.2) after IPTW adjustment, with significant associations persisting among those with risk factors such as smoking and dyslipidemia.Conclusion: This study highlights a significant association between CSA and left atrial enlargement in males with preserved EF, suggesting that CSA may contribute to atrial remodeling even without reduced ejection fraction.Keywords: central sleep apnea, left atrial enlargement, preserved ejection fractionhttps://www.dovepress.com/association-between-central-sleep-apnea-and-left-atrial-enlargement-in-peer-reviewed-fulltext-article-NSScentral sleep apnealeft atrial enlargementpreserved ejection fraction
spellingShingle Sun X
Wang Y
Wu C
Gao Y
Association Between Central Sleep Apnea and Left Atrial Enlargement in Snoring Patients with Preserved Ejection Fraction
Nature and Science of Sleep
central sleep apnea
left atrial enlargement
preserved ejection fraction
title Association Between Central Sleep Apnea and Left Atrial Enlargement in Snoring Patients with Preserved Ejection Fraction
title_full Association Between Central Sleep Apnea and Left Atrial Enlargement in Snoring Patients with Preserved Ejection Fraction
title_fullStr Association Between Central Sleep Apnea and Left Atrial Enlargement in Snoring Patients with Preserved Ejection Fraction
title_full_unstemmed Association Between Central Sleep Apnea and Left Atrial Enlargement in Snoring Patients with Preserved Ejection Fraction
title_short Association Between Central Sleep Apnea and Left Atrial Enlargement in Snoring Patients with Preserved Ejection Fraction
title_sort association between central sleep apnea and left atrial enlargement in snoring patients with preserved ejection fraction
topic central sleep apnea
left atrial enlargement
preserved ejection fraction
url https://www.dovepress.com/association-between-central-sleep-apnea-and-left-atrial-enlargement-in-peer-reviewed-fulltext-article-NSS
work_keys_str_mv AT sunx associationbetweencentralsleepapneaandleftatrialenlargementinsnoringpatientswithpreservedejectionfraction
AT wangy associationbetweencentralsleepapneaandleftatrialenlargementinsnoringpatientswithpreservedejectionfraction
AT wuc associationbetweencentralsleepapneaandleftatrialenlargementinsnoringpatientswithpreservedejectionfraction
AT gaoy associationbetweencentralsleepapneaandleftatrialenlargementinsnoringpatientswithpreservedejectionfraction