Effect of obstructive sleep apnea syndrome on cardiac functions

Introduction-Aim: OSAS is an important clinical condition that can lead to serious health problems, with adverse effects on all organs and systems, especially the cardiovascular system, and metabolic events. It has been observed that the incidence of OSAS has increased in recent years, The cardiovascular diseases (CVD) seen in patients with OSAS and its relationship with high mortality are emphasized. In this work, it was aimed to examine the effects of OSAS on cardiac functions and to reveal the related factors. Material-Method: This work was planned as retrospective, cross-sectional and descriptive. A total of 64 patients who were followed up with the diagnosis of OSAS in the Chest Diseases and Sleep Clinic of the Harran University Medical Faculty Hospital in the last ten years and whose electrocardiogram, echocardiography and polysomnography reports were registered were included in the study. In the work, recorded sociodemographic characteristics and anthropometric measurements of the patients (body fat ratio, body mass index (BMI), waist-neck thickness), cardiac parameters (left ventricular (LV) EF%, aortic velocity, pulmonary velocity, tricuspid annular plane systolic movement ( TAPSE).), sleep-related parameters (sleep latency, REM - NREM time), respiratory events, lying position, and apnea-hypone index-oxygen desaturation index values were reviewed. Statistical Package for Social Science (SPSS) 25.0 program was used in the analysis of the data obtained. The conformity of the data to the normal distribution was evaluated with Kolmogorov-Smirnov and Shapiro-Wilk tests. Quantitative data are shown as mean, standard deviation, and categorical variables as number of cases (n) and percentage (%). The statistical significance of the differences between the data was investigated using the independet t test, pearson correlation analysis, and paired simples t test. The hypotheses were designed as bidirectional and values with p value less than 0.05 were accepted as important. Results: A total of 64 patients, 35 (54.7%) male and 29 (45.3%) female, were included in the work. The ages of the patients ranged from 25 to 69 years, with a mean age of 47.59±11.63 years. A statistically inverse significant difference was found between the fat ratio values of the patients and their genders. Statistically inversely significant was found between BMI values and XI gender. There was no statistically significant difference between waist measurements and gender. The patients in our study were found to have moderate apnea-hypopnea index. It was noteworthy that the Rem AHI and Non Rem AHI values of the patients evaluated within the scope of the study had close averages. No statistically significant difference was found between the cardiac parameters of the patients and their gender. Conclusion: Our findings revealed that OSAS is associated with cardiac dysfunction and that body fat ratio, BMI and waist circumference thickness are significantly increased in patients with OSAS. It is obvious that cardiac dysfunction due to OSAS is associated with increased mortality. In this respect, it is seen that family physicians responsible for health service delivery in primary care are in a critical position in preventing obesity, which is one of the significant risk factors of OSAS. It can be said that effective counseling by family physicians and follow-up of OSAS patients in coordination with chest diseases specialists and cardiologists is a rational approach in terms of protecting and improving health. In our study, neck circumference thickness was also found to be importantly increased in OSAS patients. Neck circumference measurement is a simple, non-invasive method that can be useful in estimating cardiovascular disease risk. Measurement of neck circumference in primary health care services may help predict the potential for OSAS development and therefore the risk of cardiovascular disease. Keywords: Obstructive sleep apnea syndrome, Sleep hypopnea, Body Mass Index, Sleep, RE