{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T19:06:04Z","timestamp":1790363164714,"version":"4.1.0"},"reference-count":30,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Obstructive Sleep Apnea Syndrome (OSAS) is a chronic disorder characterized by repeated upper airway obstruction during sleep, leading to intermittent hypoxia and elevated sympathetic activity. OSAS is strongly linked to cardiovascular comorbidities such as hypertension, arrhythmias, heart failure, and atherosclerosis, contributing to structural and functional cardiac alterations. Methods: This study enrolled 105 consecutive patients diagnosed with OSAS and a control group of 100 patients without the syndrome. All participants underwent a comprehensive echocardiographic evaluation using Doppler imaging to assess cardiac structure and function. Results: Hypertension was significantly more prevalent in the OSAS group (81%) compared to controls (74%). Left ventricular diastolic dysfunction occurred in 56.2% of OSAS patients versus 26% of controls. Left atrial enlargement and left ventricular hypertrophy were also more frequent in the OSAS group (21% and 51.4%, respectively) compared to controls (13% and 5%). Permanent atrial fibrillation was present in 17.1% of OSAS patients, significantly higher than the 7% observed in controls. These findings highlight the pronounced cardiac remodeling and arrhythmic burden associated with OSAS. Conclusions: The data confirm that OSAS is associated with increased cardiovascular abnormalities detectable by echocardiography, underscoring the need for routine cardiovascular screening in OSAS patients. Given the systemic implications of OSAS beyond sleep disturbances, a multidisciplinary approach is essential for early diagnosis and optimized management, aiming to mitigate cardiovascular risk and improve outcomes. OSAS is a significant cardiovascular risk factor requiring comprehensive clinical attention.<\/jats:p>","DOI":"10.3390\/jcm15031239","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T14:55:11Z","timestamp":1770216911000},"page":"1239","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Beyond Sleep: The Cardiovascular Impact of Obstructive Sleep Apnea Syndrome"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8285-1623","authenticated-orcid":false,"given":"Pasquale","family":"Palmiero","sequence":"first","affiliation":[{"name":"Cardiology Equipe, ASL Brindisi, 72100 Brindisi, Italy"},{"name":"Medical School, University of Bari, 70122 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7101-7701","authenticated-orcid":false,"given":"Francesca","family":"Amati","sequence":"additional","affiliation":[{"name":"University Cardiology Unit, Interdisciplinary Department of Medicine, Polyclinic University Hospital, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucrezia","family":"Bombini","sequence":"additional","affiliation":[{"name":"University Cardiology Unit, Interdisciplinary Department of Medicine, Polyclinic University Hospital, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco Matteo","family":"Ciccone","sequence":"additional","affiliation":[{"name":"University Cardiology Unit, Interdisciplinary Department of Medicine, Polyclinic University Hospital, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Maiello","sequence":"additional","affiliation":[{"name":"Cardiology Equipe, ASL Brindisi, 72100 Brindisi, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3627","DOI":"10.1093\/eurheartj\/ehad195","article-title":"2023 Focused Update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"44","author":"McDonagh","year":"2023","journal-title":"Eur. Heart J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3021","DOI":"10.1093\/eurheartj\/ehy339","article-title":"2018 ESC\/ESH Guidelines for the management of arterial hypertension","volume":"39","author":"Williams","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"370","DOI":"10.3109\/03009734.2012.707253","article-title":"Obstructive sleep apnea syndrome (OSAS) and hypertension: Pathogenic mechanisms and possible therapeutic approaches","volume":"117","author":"Zhang","year":"2012","journal-title":"Upsala J. Med. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1038\/hr.2014.80","article-title":"Obstructive sleep apnea syndrome as a cause of resistant hypertension","volume":"37","author":"Parati","year":"2014","journal-title":"Hypertens. Res."},{"key":"ref_5","first-page":"294","article-title":"Obstructive sleep apnea syndrome is a risk factor for hypertension","volume":"107","author":"Meng","year":"2016","journal-title":"Minerva Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1038\/jhh.2008.147","article-title":"Hypertension and obstructive sleep apnoea syndrome: Current perspectives","volume":"23","author":"Baguet","year":"2009","journal-title":"J. Hum. Hypertens."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1111\/echo.15305","article-title":"The relationship of interleukin-6 and C-reactive protein with left ventricular geometry and function in patients with obstructive sleep apnea syndrome and pre-hypertension","volume":"39","author":"Cui","year":"2022","journal-title":"Echocardiography"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Zhang, Y., Shui, W., Tian, Y., Zhang, Z., Li, J., and Wang, J. (2021). The impact of left ventricular geometry on left atrium phasic function in obstructive sleep apnea syndrome: A multimodal echocardiography investigation. BMC Cardiovasc. Disord., 21.","DOI":"10.1186\/s12872-021-02018-1"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1016\/j.acvd.2016.02.011","article-title":"Consequences of obstructive sleep apnoea syndrome on left ventricular geometry and diastolic function","volume":"109","author":"Bodez","year":"2016","journal-title":"Arch. Cardiovasc. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1097\/00004872-199010000-00009","article-title":"Left ventricular hypertrophy independent of hypertension in patients with obstructive sleep apnoea","volume":"8","author":"Hedner","year":"1990","journal-title":"J. Hypertens."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1007\/s00059-019-04850-w","article-title":"Left ventricular remodeling and dysfunction in obstructive sleep apnea: Systematic review and meta-analysis","volume":"45","author":"Yu","year":"2020","journal-title":"Herz"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1016\/j.acvd.2015.03.006","article-title":"Left ventricular diastolic dysfunction in obstructive sleep apnoea syndrome by an echocardiographic standardized approach: An observational study","volume":"108","author":"Bodez","year":"2015","journal-title":"Arch. Cardiovasc. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"519","DOI":"10.5603\/CJ.2013.0043","article-title":"Early left ventricular functional alterations in patients with obstructive sleep apnea syndrome","volume":"20","author":"Aslan","year":"2013","journal-title":"Cardiol. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1538","DOI":"10.1378\/chest.107.6.1538","article-title":"Cardiac hypertrophy in obstructive sleep apnea syndrome","volume":"107","author":"Noda","year":"1995","journal-title":"Chest"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.ijcard.2016.12.120","article-title":"Obstructive sleep and atrial fibrillation: Pathophysiological mechanisms and therapeutic implications","volume":"230","author":"Goudis","year":"2017","journal-title":"Int. J. Cardiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1016\/j.hrthm.2012.03.024","article-title":"Determinants of atrial fibrillation in an animal model of obesity and acute obstructive sleep apnea","volume":"9","author":"Iwasaki","year":"2012","journal-title":"Heart Rhythm"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Thareja, S., Mandapalli, R., Shaik, F., Pillai, A.R., Palaniswamy, G., Sahu, S., Cherukuri, S.P., and Younas, S. (2024). Impact of Obstructive Sleep Apnea on Cardiovascular Health: A Systematic Review. Cureus, 16.","DOI":"10.7759\/cureus.71940"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/j.jacc.2006.08.060","article-title":"Obstructive sleep apnea, obesity, and the risk of incident atrial fibrillation","volume":"49","author":"Gami","year":"2007","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1164\/rccm.200509-1442OC","article-title":"Association of nocturnal arrhythmias with sleep-disordered breathing: The Sleep Heart Health Study","volume":"173","author":"Mehra","year":"2006","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1001\/jamacardio.2018.0095","article-title":"Associations of obstructive sleep apnea with atrial fibrillation and continuous positive airway pressure treatment: A review","volume":"3","author":"Linz","year":"2018","journal-title":"JAMA Cardiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"42","author":"Hindricks","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Ahmed, A.M., Nur, S.M., and Xiaochen, Y. (2023). Association between obstructive sleep apnea and resistant hypertension: Systematic review and meta-analysis. Front. Med., 10.","DOI":"10.3389\/fmed.2023.1200952"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1858","DOI":"10.1378\/chest.07-1170","article-title":"Obstructive sleep apnea and resistant hypertension: A case-control study","volume":"132","author":"Martinez","year":"2007","journal-title":"Chest"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"165","DOI":"10.5664\/jcsm.2420","article-title":"Effect of oral appliances on blood pressure in obstructive sleep apnea: A systematic review and meta-analysis","volume":"9","author":"Iftikhar","year":"2013","journal-title":"J. Clin. Sleep Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1164\/rccm.201601-0088OC","article-title":"Effect of Positive Airway Pressure on Cardiovascular Outcomes in Coronary Artery Disease Patients with Nonsleepy Obstructive Sleep Apnea. The RICCADSA Randomized Controlled Trial","volume":"194","author":"Peker","year":"2016","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_26","first-page":"2161","article-title":"Effect of continuous positive airway pressure on the incidence of hypertension and cardiovascular events in nonsleepy patients with obstructive sleep apnea: A randomized controlled trial","volume":"307","author":"Carmona","year":"2012","journal-title":"JAMA"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1056\/NEJMoa1606599","article-title":"CPAP for Prevention of Cardiovascular Events in Obstructive Sleep Apnea","volume":"375","author":"McEvoy","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1016\/S0140-6736(05)71141-7","article-title":"Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: An observational study","volume":"365","author":"Marin","year":"2005","journal-title":"Lancet"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Chen, H., Zhang, Q., Hao, Y., Zhang, J., He, Y., and Hu, K. (2024). Cardiac autonomic dysfunction and structural remodeling: The potential mechanism to mediate the relationship between obstructive sleep apnea and cardiac arrhythmias. Front. Med., 11.","DOI":"10.3389\/fmed.2024.1346400"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Battisha, A., Kahlon, A., and Kalra, D.K. (2024). Sleep-Disordered Breathing and Hypertension Systematic Review. J. Clin. Med., 14.","DOI":"10.3390\/jcm14093115"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/3\/1239\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T15:00:44Z","timestamp":1770217244000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/3\/1239"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,4]]},"references-count":30,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["jcm15031239"],"URL":"https:\/\/doi.org\/10.3390\/jcm15031239","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,4]]}}}