ABC | Volume 113, Nº6, December 2019

Original Article Leite et al. Risk of sleep apnea and echocardiographic parameters Arq Bras Cardiol. 2019; 113(6):1084-1089 Table 2 – Median with interquartile* range or absolute and relative frequency ** of echocardiographic parameters according to the presence of high risk of OSA modified High risk of OSA modified p value Yes No ILAD (cm/m 2 ) 1.9 (1.7–2.1) 1.9 (1.7–2.0) 0.37 ILAV-i (ml/m 2 ) 21.1 (17.7–24.9) 19.9 (16.8–22.7) 0.01 DT (ms) 228.0 (186.0–261.0) 200.0 (174.0–228.0) < 0.01 E’ (cm/s) 10.0 (8.0–12.0) 11.5 (9.0–13.0) < 0.01 E’/A’ 0.83 (0.64–1.20 1.14 (0.80–1.37) < 0.01 E/E’ 6.4 (5.4–7.8) 6.0 (5.0–7.0) 0.02 E (cm/s) 63.0 (53.0–76.0) 66.1 (54.0–75.0) 0.31 A (cm/s) 68.0 (56.0–81.9) 58.0 (48.0–68.0) < 0.01 E/A 0.93 (0.7–1.2) 1.18 (0.9–1.4) < 0.01 ILVM (g/m 2 ) 89.4 (77.3–103.6) 88.7 (74.4–102.0) 0.49 IFDV (ml/m 2 ) 62.08 (53.5–68.7) 63.8 (54.0–72.3) 0.15 RWT (mm) 0.3 (0.3–0.4) 0.3 (0.3–0.4) 0.28 IPWT (mm) 8.0 (7.0–9.0) 8.0 (7.0–8.0) 0.03 ILVDD (mm) 49.0 (46.0–51.0) 48.0 (45.0–51.0) 0.53 IVS (mm) 8.0 (7.0–9.0) 8.0 (7.0–9.0) 0.02 ILAD: indexed left atrial diameter; LAV-i: indexed left atrial volume; WT:E’ wave deceleration time; E: early diastolic mitral annular velocity; E’/A’: early diastolic mitral flow velocity; A:atrial contraction; ILVM: indexed left ventricular mass; IFDV: indexed final diastolic volume; RWT: relative wall thickness; IPWT: indexed posterior wall thickness; ILVDD: indexed diastolic left ventricular diameter; IVS: intraventricular septum. *Differences tested by the Mann-Whitney test; ** Differences tested by Pearson’s qui-square test with correction by Fisher’s exact test when necessary.****** Individuals who were classified as at risk only in category 3 were excluded (Adapted from Netzer et al., 1999). 5 Table 3 – Exponentials of gamma regression** adjusted coefficients* of the presence of high risk of OSA (yes/no)*** Exponential of the adjusted coefficient p value LAV-i (ml/m 2 ) 1.10 (1.02–1.18) 0.02 TD (ms) 1.05 (0.99–1.11) 0.10 E’ 1.05 (0.99–1.11) 0.10 E’/A’ 0.87 (0.72–0.96) < 0.01 E/E’ 1.01 (0.94–1.09) 0.81 A 1.10 (1.02–1.18) 0.02 E/A 0.86 (0.79–0.94) < 0.01 IEPP (mm) 1.02 (0.98–1.06) 0.24 SIV (mm) 1.02 (0.98–1.06) 0.42 LAV-i: indexed left atrial volume; WT: E’ wave deceleration time; E: early diastolic mitral annular velocity; E’/A’: early diastolic mitral flow velocity; A: atrial contraction; IPWT: indexed posterior wall thickness; IVS: intraventricular septum*. For each regression model whose outcome was an echocardiographic parameter, exponentials of the coefficients were adjusted for gender, age, BMI, fasting glucose, triglycerides, serum uric acid, urine albumin/creatinine ratio and systolic and diastolic arterial pressure in their continuous forms (mmHg), **Gamma regression with log link function; ***Berlin Questionnaire. We observed that LAV-i, a marker of diastolic disfunction, presents a strong association with the presence of high risk of OSA, identified by the BQ, regardless of the presence of hypertension or obesity, when not associated with an indicator of the risk of OSA. Wachter et al. 3 investigated if OSA affects diastolic function in a primary care cohort and observed that diastolic function is independently associated with OSA in patients with cardiovascular risk factors. 3 Gottlieb et al. observed that in patients without HF and coronary arterial disease, the presence of OSA was an independent HF predictor in men and not in women. 19 In another study, Usui et al. 20 demonstrated that the severity of OSA may contribute directly to LV diastolic disfunction regardless of LV geometry, arterial stiffness, obesity and is associated with cardiovascular risk factors. 20 1087