Impact of obstructive sleep apnea on cardiac diastolic dysfunction: A meta⁃analysis

TIAN Haiyan; WANG Yanggan

doi:10.14188/j.1671-8852.2026.0808

您当前的位置：

首页 >

文章列表页 >

Impact of obstructive sleep apnea on cardiac diastolic dysfunction: A meta⁃analysis

更新时间：2026-10-10

- Impact of obstructive sleep apnea on cardiac diastolic dysfunction: A meta⁃analysis
- Medical Journal of Wuhan University Pages: 1-9(2026)
- 作者机构：
  
  武汉大学中南医院老年医学科湖北武汉 430071
- 作者简介：
- 基金信息：
- DOI：10.14188/j.1671-8852.2026.0808
  CLC： R563.8
- Received：16 May 2026，
  
  Online First：10 October 2026，
- 稿件说明：
移动端阅览
TIAN Haiyan, WANG Yanggan. Impact of obstructive sleep apnea on cardiac diastolic dysfunction: A meta⁃analysis[J/OL]. Medical Journal of Wuhan University, 2026, 1-9.
DOI：

TIAN Haiyan, WANG Yanggan. Impact of obstructive sleep apnea on cardiac diastolic dysfunction: A meta⁃analysis[J/OL]. Medical Journal of Wuhan University, 2026, 1-9. DOI： 10.14188/j.1671-8852.2026.0808.

摘要

目的

系统评价阻塞性睡眠呼吸暂停（OSA）与心脏舒张功能障碍相关超声心动图指标的关系。

方法

检索PubMed、Embase、Web of Science、Cochrane Library、中国知网、万方和维普数据库，检索时限为建库至2026年5月16日。采用纽卡斯尔⁃渥太华量表评价研究质量，应用固定或随机效应模型合并均数差（

），并进行亚组分析、逐一剔除敏感性分析及Begg秩相关检验。

结果

纳入21项成人观察性研究，共2 612例。OSA组左心室射血分数与对照组差异无统计学意义（

=-0.53，95%

：-1.31~0.24），但左心室质量指数、左心房容积指数、二尖瓣舒张早期血流减速时间、等容舒张时间、E/e′及收缩期肺动脉压升高，E/A降低（均

0.05）。逐一剔除研究后效应方向未变，其中左心室质量指数、E/A、等容舒张时间及E/e′结果最稳定；Begg检验未见明显发表偏倚。

结论

OSA与左心室肥厚、左心房重构、舒张松弛受损及充盈压升高相关，心脏舒张功能异常可能早于左心室射血分数下降出现。

Abstract

Objective

To systematically review the association between obstructive sleep apnea (OSA) and echocardiographic indices of cardiac diastolic dysfunction.

Methods

PubMed

Embase

Web of Science

the Cochrane Library

CNKI

Wanfang

and VIP were searched from inception to May 16

2026. Study quality was assessed using the Newcastle⁃Ottawa Scale. Mean differences (

s) were pooled using fixed⁃ or random⁃effects models. Subgroup analyses

leave⁃one⁃out sensitivity analyses

and Begg rank correlation tests were performed.

Results

Twenty⁃one adult observational studies involving 2 612 participants were included. Left ventricular ejection fraction did not differ significantly between the OSA and control groups (

=-0.53

95%

: -1.31 to 0.24). In contrast

OSA was associated with higher left ventricular mass index

left atrial volume index

deceleration time

isovolumic relaxation time

E/e′ ratio

and systolic pulmonary artery pressure

together with a lower E/A ratio (all

0.05). Leave⁃one⁃out analyses did not alter the direction of any pooled effect; the results for left ventricular mass index

E/A ratio

isovolumic relaxation time

and E/e′ ratio

were the most robust. Begg tests indicated no significant publication bias.

Conclusion

OSA is associated with cardiac structural remodeling

impaired ventricular relaxation

and elevated filling pressure. Diastolic abnormalities may occur before a detectable reduction in left ventricular ejection fraction.

关键词

Keywords

references

SARKAR P , MUKHERJEE S , CHAI⁃COETZER C L , et al . The epidemiology of obstructive sleep apnoea and cardiovascular disease [J ] . J Thorac Dis , 2018 , 10 ( Suppl 34 ): S4189 ⁃S4200.

ZHU J , WU D Y , CHEN S Y , et al . Increased vascular endothelial growth factor receptor 2 levels are associated with a higher occurrence of coronary artery disease in patients with obstructive sleep apnea [J ] . Rev Cardiovasc Med , 2026 , 27 ( 4 ): 46087 .

TURNBULL C D . Intermittent hypoxia, cardiovascular disease and obstructive sleep apnoea [J ] . J Thorac Dis , 2018 , 10 ( Suppl 1 ): S33 ⁃S39.

PANTHEE A , CHAULAGAIN R , PAUDYAL K P , et al . Effectiveness of customized oral appliances in mild⁃to⁃moderate obstructive sleep apnea: A systematic review of randomized controlled trials [J ] . Oral Dis , 2026 . DOI: 10.1111/odi.70351 http://dx.doi.org/10.1111/odi.70351 .

MERAL D , MAMAZHAKYPOV A , KOCA D , et al . Reversible fibroblast trajectories regulated by MR underlie diastolic dysfunction [J ] . Circ Res , 2026 , 138 ( 11 ): e327301 .

PANAOU K , VENEMA C S , VAN BERGEIJK K H , et al . Characteristics, clinical outcomes and molecular mechanisms associated with severe diastolic dysfunction in aortic stenosis [J ] . J Mol Cell Cardiol Plus , 2026 , 16 : 100845 .

AKAR BAYRAM N , CIFTCI B , DURMAZ T , et al . Effects of continuous positive airway pressure therapy on left ventricular function assessed by tissue Doppler imaging in patients with obstructive sleep apnoea syndrome [J ] . Eur J Echocardiogr , 2009 , 10 ( 3 ): 376 ⁃ 382 .

ALTEKIN R E , YANIKOGLU A , BAKTIR A O , et al . Assessment of subclinical left ventricular dysfunction in obstructive sleep apnea patients with speckle tracking echocardiography [J ] . Int J Cardiovasc Imaging , 2012 , 28 ( 8 ): 1917 ⁃ 1930 .

ALTıPARMAK İ H , ERKUŞ M E , POLAT M , et al . Relation of elastic properties of pulmonary artery with left ventricular abnormalities and aortic stiffness in patients with moderate to severe obstructive sleep apnea: a cross⁃sectional echocardiographic study [J ] . Turk Kardiyol Dern Ars , 2016 , 44 ( 4 ): 289 ⁃ 299 .

ARIAS M A , GARCÍA⁃RÍO F , ALONSO⁃FERNÁNDEZ A , et al . Obstructive sleep apnea syndrome affects left ventricular diastolic function: effects of nasal continuous positive airway pressure in men [J ] . Circulation , 2005 , 112 ( 3 ): 375 ⁃ 383 .

ARIKAWA T , TOYODA S , HARUYAMA A , et al . Impact of obstructive sleep apnoea on heart failure with preserved ejection fraction [J ] . Heart Lung Circ , 2016 , 25 ( 5 ): 435 ⁃ 441 .

BUTT M , DWIVEDI G , SHANTSILA A , et al . Left ventricular systolic and diastolic function in obstructive sleep apnea: Impact of continuous positive airway pressure therapy [J ] . Circ Heart Fail , 2012 , 5 ( 2 ): 226 ⁃ 233 .

CICEK D , LAKADAMYALI H , YAĞBASAN B D , et al . Obstructive sleep apnoea and its association with left ventricular function and aortic root parameters in newly diagnosed, untreated patients: A prospective study [J ] . J Int Med Res , 2011 , 39 ( 6 ): 2228 ⁃ 2238 .

DANICA L P , KROTIN M , ZDRAVKOVIC M , et al . Early left ventricular systolic and diastolic dysfunction in patients with newly diagnosed obstructive sleep apnoea and normal left ventricular ejection fraction [J ] . Sci World J , 2014 , 2014 ( 1 ): 898746 .

GLANTZ H , THUNSTRÖM E , JOHANSSON M C , et al . Obstructive sleep apnea is independently associated with worse diastolic function in coronary artery disease [J ] . Sleep Med , 2015 , 16 ( 1 ): 160 ⁃ 167 .

HARUKI N , TAKEUCHI M , NAKAI H , et al . Overnight sleeping induced daily repetitive left ventricular systolic and diastolic dysfunction in obstructive sleep apnoea: Quantitative assessment using tissue Doppler imaging [J ] . Eur J Echocardiogr , 2009 , 10 ( 6 ): 769 ⁃ 775 .

KAWANISHI Y , ITO T , OKUDA N , et al . Alteration of myocardial characteristics and function in patients with obstructive sleep apnea [J ] . Int J Cardiol , 2009 , 133 ( 1 ): 129 ⁃ 131 .

KIM S H , CHO G Y , SHIN C , et al . Impact of obstructive sleep apnea on left ventricular diastolic function [J ] . Am J Cardiol , 2008 , 101 ( 11 ): 1663 ⁃ 1668 .

KOGA S , IKEDA S , URATA J , et al . Effect of nasal continuous positive airway pressure in men on global left ventricular myocardial performance in patients with obstructive sleep apnea syndrome [J ] . Am J Cardiol , 2008 , 101 ( 12 ): 1796 ⁃ 1800 .

LISI E , FAINI A , BILO G , et al . Diastolic dysfunction in controlled hypertensive patients with mild⁃moderate obstructive sleep apnea [J ] . Int J Cardiol , 2015 , 187 : 686 ⁃ 692 .

ROMERO⁃CORRAL A , SOMERS V K , PELLIKKA P A , et al . Decreased right and left ventricular myocardial performance in obstructive sleep apnea [J ] . Chest , 2007 , 132 ( 6 ): 1863 ⁃ 1870 .

SHIVALKAR B , VAN DE HEYNING C , KERREMANS M , et al . Obstructive sleep apnea syndrome more insights on structural and functional cardiac alterations, and the effects of treatment with continuous positive airway pressure [J ] . J Am Coll Cardiol , 2006 , 47 ( 7 ): 1433 ⁃ 1439 .

WACHTER R , LÜTHJE L , KLEMMSTEIN D , et al . Impact of obstructive sleep apnoea on diastolic function [J ] . Eur Respir J , 2013 , 41 ( 2 ): 376 ⁃ 383 .

YANG S Q , HAN L L , DONG X L , et al . Mal⁃effects of obstructive sleep apnea on the heart [J ] . Sleep Breath , 2012 , 16 ( 3 ): 717 ⁃ 722 .

ABD ELGHANY O S A A , ELESSAWY A F , ELKHASHAB K A , et al . Correlation between obstructive sleep apnea and ventricular function: A cross⁃sectional hospital⁃based study [J ] . Acta Cardiol , 2023 , 78 ( 7 ): 805 ⁃ 812 .

ZHANG Y , ZHU S Y . The AutoStrain LV technique is a sensitive method for detecting subclinical left ventricular dysfunction in patients with obstructive sleep apnea syndrome [J ] . Medicine , 2025 , 104 ( 18 ): e42309 .

MAIOLINO G , BISOGNI V , MAGGI M , et al . Nocturnal hypoxia indexes are associated with left ventricular remodeling and diastolic dysfunction in obstructive sleep apnea patients [J ] . Sleep Med , 2023 , 103 : 180 ⁃ 186 .

MACEDO T A , GIAMPÁ S Q C , FURLAN S F , et al . Effect of continuous positive airway pressure on atrial remodeling and diastolic dysfunction of patients with obstructive sleep apnea and metabolic syndrome: A randomized study [J ] . Obesity , 2023 , 31 ( 4 ): 934 ⁃ 944 .

KAMELIA T , MAKMUN L H . The role of new pulmonary artery wedge pressure formula to predict diastolic dysfunction in obstructive sleep apnea [J ] . Acta Med Indones , 2023 , 55 ( 1 ): 40 ⁃ 51 .

KUWAKI H , TAKEUCHI M , CHIEN⁃CHIA WU V , et al . Redefining diastolic dysfunction grading combination of E/a ≤0.75 and deceleration time >140 ms and E/ε' ≥10 [J ] . JACC Cardiovasc Imaging , 2014 , 7 ( 8 ): 749 ⁃ 758 .

BLESSING M , KÖRPERICH H , BARTH P , et al . Influence of respiration on collateral flow in the fontan population using real⁃time phase⁃contrast cardiovascular magnetic resonance: Collateral flow does not protect the ventricle from volume deficiency and diastolic dysfunction [J ] . J Thorac Imaging , 2023 , 38 ( 5 ): W64 ⁃W74.

ALVARADO A C , PINSKY M R . Cardiopulmonary interactions in left heart failure [J ] . Front Physiol , 2023 , 14 : 1237741 .

LAMY J , XIANG J , SHAH N , et al . Diastolic dysfunction evaluation by cardiovascular magnetic resonance derived E, a, E': Comparison to echocardiography [J ] . Physiol Rep , 2024 , 12 ( 23 ): e70078 .

BARASCH E , KHALIQUE O K . Is it time to retire LVEF as a predictive metric in HFpEF? [J ] . Circ Cardiovasc Imaging , 2025 , 18 ( 9 ): e018785 .

TADIC M , CUSPIDI C , GRASSI G , et al . Obstructive sleep apnea and cardiac mechanics: How strain could help us? [J ] . Heart Fail Rev , 2021 , 26 ( 4 ): 937 ⁃ 945 .

MARTINOT J B , LE⁃DONG N N , CANTERO C , et al . Dose⁃response relationship between mandibular advancement and OSA burden: Dissociated effects on supine and non⁃supine AHI [J ] . Sleep Med , 2026 , 144 : 108996 .

BARTOLUCCI M L , INCERTI PARENTI S , BORTOLOTTI F , et al . The effect of bite raise on AHI values in adult patients affected by OSA: a systematic review with meta⁃regression [J ] . J Clin Med , 2023 , 12 ( 11 ): 3619 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Echocardiography evaluation of the mid⁃ and long⁃term efficacy and prognosis in patients with aortic insufficiency treated by transcatheter aortic valve implantation

Safety and effectiveness of high⁃frequency oscillatory ventilation for the treatment of acute respiratory distress syndrome: A meta⁃analysis

Efficacy and safety of sucrose⁃hydroxy iron oxide in the treatment of hyperphosphatemia and uremic anemia in dialysis patients: A meta⁃analysis

A meta analysis on the efficacy of cervical cerclage in the treatment of placenta previa

Effect of opioid analgesia on postoperative intestinal recovery： A meta⁃analysis

Related Author

HE Feng

TAO Shixin

MEI Dan'e

CHEN Liao

CHEN Jinling

LIU Zhou

ZHANG Liang

LI Guang

Related Institution

Department of Ultrasound, Hongshan Branch, Renmin Hospital of Wuhan University

Department of Ultrasound, Wuhan Central Hospital

Department of Critical Care Medicine, Renmin Hospital of Wuhan University

Department of Radiology, Renmin Hospital of Wuhan University

Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital

AI问答

⁰