Treating Apnea Reverses Heart Enlargement

By Will Boggs, MD - August 19, 2003

In people with sleep apnea -- breathing that becomes irregular or even stops periodically when they sleep -- the left side of their heart often becomes enlarged, researchers have found. The good news is that treating the apnea problem can reverse the heart enlargement.

Obstructive sleep apnea is known to lead to high blood pressure, explain the authors of a report in the medical journal Chest, but whether apnea contributes to left-sided heart enlargement, which could lead to heart failure, has been controversial.

Dr. Tom V. Cloward from LDS Hospital's Intermountain Sleep Disorders Center in Salt Lake City, Utah, and associates used ultrasound to measure the hearts of 25 patients with severe obstructive sleep apnea before and after they were treated with continuous pressurized air delivered via the nasal passages while they slept.

Twenty-three of the 25 patients had abnormalities in the structure of their heart, the physicians found, with 22 showing left-sided enlargement. Only thirteen of the patients had high blood pressure, but all of them also had enlarged hearts.

The dimensions of the heart showed significant improvement in 20 of the patients who complied with continuous positive airway pressure therapy, the team reports. On the other hand, those who could not stick to the treatment showed no significant change.

Dr. Cloward told Reuters Health he was surprised to find that nearly all of the subjects had left-sided heart enlargement. "Of course, this study looked at people with severe sleep apnea," he pointed out, so it remains to be seen how many patients with mild or moderate sleep apnea have the same problem.

Meanwhile, Dr. Cloward added, "Continuous positive airway pressure is the treatment of choice for sleep apnea." If patients find this treatment too troublesome to tolerate, "then the goals should focus on tight blood pressure control and monitoring, and weight loss."

Source: Chest, August 2003.