Cardiovascular Pathology in Obstructive Sleep Apnea: A Retrospective Autopsy Study
Laura M Warmke, Margaret M Grimes. Virginia Commonwealth University Medical Center, Richmond, VA
Background: Obstructive sleep apnea (OSA) results in chronic intermittent hypoxia and is associated with cardiovascular disease (CVD). Imaging studies have demonstrated increased left ventricular mass and greater coronary atherosclerotic plaque burden in OSA compared to non-OSA patients. Only one previous autopsy study of CVD in OSA is identified in the literature. Since obesity is a risk factor for both OSA and CVD, we compared cardiovascular pathology at autopsy in obese patients with and without documented OSA.
Design: Autopsy records were searched for patients with a clinical history of OSA. Of 27 patients with OSA, 23 were obese (BMI≥31) and comprised the study group (n=23). The control group consisted of obese patients without documented OSA (n=25). Autopsy reports were reviewed for medical histories and gross descriptions of cardiovascular pathology. Recorded heart weights were compared to predicted heart weights for body weight and gender. Histologic sections of myocardium and arteries were reviewed in a blinded fashion.
Results: The two groups had no significant difference in age, gender, race, height or prevalence of ischemic heart disease, hypertension, diabetes, stroke, or history of smoking.
|Heart wt (g)||665.1±204.0||588.7±126.0||0.16|
|Heart wt >predicted (g)||280.0±203.5 (n=20)||186.6±113.8 (n=18)||0.11|
|Heart wt >upper 95% CL* (g)||256.3±157.0 (n=13)||95.1±69.1 (n=12)||0.005|
|RV wall thickness (cm)||0.47±0.21||0.50±0.16||0.62|
|LV wall thickness (cm)||1.83±0.58||1.59±0.43||0.16|