Association Between Sleep Disordered Breathing and Left Ventricular Function: A Cross-Sectional Analysis of the ECHO-SOL Ancillary Study

Circ Cardiovasc Imaging. 2020 May;13(5):e009074. doi: 10.1161/CIRCIMAGING.119.009074. Epub 2020 May 15.


Background: Prior studies have found that sleep-disordered breathing (SDB) is common among those with left ventricular (LV) dysfunction and heart failure. Few epidemiological studies have examined this association, especially in US Hispanic/Latinos, who may be at elevated risk of SDB and heart failure.

Methods: We examined associations between SDB and LV diastolic and systolic function using data from 1506 adults aged 18 to 64 years in the Hispanic Community Health Study/Study of Latinos ECHO-SOL Ancillary Study (2011-2014). Home sleep testing was used to measure the apnea-hypopnea index, a measure of SDB severity. Echocardiography was performed a median of 2.1 years later to quantify LV diastolic function, systolic function, and structure. Multivariable linear regression was used to model the association between apnea-hypopnea index and echocardiographic measures while accounting for the complex survey design, demographics, body mass, and time between sleep and echocardiographic measurements.

Results: Each 10-unit increase in apnea-hypopnea index was associated with 0.2 (95% CI, 0.1-0.3) lower E', 0.3 (0.1-0.5) greater E/E' ratio, and 1.07-fold (1.03-1.11) higher prevalence of diastolic dysfunction as well as 1.3 (0.3-2.4) g/m2 greater LV mass index. These associations persisted after adjustment for hypertension and diabetes mellitus. In contrast, no association was identified between SDB severity and subclinical markers of LV systolic function.

Conclusions: Greater SDB severity was associated with LV hypertrophy and subclinical markers of LV diastolic dysfunction. These findings suggest SDB in Hispanic/Latino men and women may contribute to the burden of heart failure in this population.

Keywords: echocardiography; epidemiology; heart failure; risk factors; sleep.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cross-Sectional Studies
  • Diastole
  • Echocardiography
  • Female
  • Heart Failure / diagnostic imaging
  • Heart Failure / ethnology
  • Heart Failure / physiopathology*
  • Hispanic or Latino
  • Humans
  • Hypertrophy, Left Ventricular / diagnostic imaging
  • Hypertrophy, Left Ventricular / ethnology
  • Hypertrophy, Left Ventricular / physiopathology*
  • Lung / physiopathology
  • Male
  • Middle Aged
  • Prevalence
  • Prognosis
  • Prospective Studies
  • Race Factors
  • Respiration
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Sleep
  • Sleep Apnea Syndromes / diagnosis
  • Sleep Apnea Syndromes / ethnology
  • Sleep Apnea Syndromes / physiopathology*
  • United States / epidemiology
  • Ventricular Dysfunction, Left / diagnostic imaging
  • Ventricular Dysfunction, Left / ethnology
  • Ventricular Dysfunction, Left / physiopathology*
  • Ventricular Function, Left*
  • Ventricular Remodeling*
  • Young Adult