Reduced left atrial early strain rate following acute sleep deprivation: chance finding or chance to find out more on the conundrum of sleep and cardiovascular disease?

摘要

There is now a large and robust body of evidence showing that the presence of severe obstructive sleep apnea (OSA) is associated with an increased risk of hypertension, atrial fibrillation, heart failure, and death [1]. In addition, epide-miological studies have also revealed associations between self-reported short sleep duration in the absence of known OSA and several cardiovascular risk factors including hypertension [2] and diabetes [3]. In this context, a number of small mechanistic studies using acute sleep deprivation models have been undertaken in healthy humans to test the hypothesis that sleep deprivation per se, i.e., in the absence of OSA, may adversely affect the cardiovascular system. In these studies, acute sleep deprivation has been shown to increase heart rate [4]; to adversely affect heart rate variability [4-6]; to increase atrial electromechanical delay [7], P wave dispersion [8], and QT dispersion [9]; to increase plasma norepinephrine [5]; and to impair vascular function [4, 5]. To date, there are very little data on the impact of sleep deprivation on cardiac function as assessed by echo-cardiography, however.