Frequent periodic leg movement during sleep is associated with left ventricular hypertrophy and adverse cardiovascular outcomes

Mahek Mirza, Win Kuang Shen, Aamir Sofi, Ahad Jehangir, Naoyo Mori, A. Jamil Tajik, Arshad Jahangir

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Background: Sleep disturbance caused by obstructive sleep apnea is recognized as a contributing factor to adverse cardiovascular outcomes. However, the effect of restless legs syndrome, another common cause of fragmented sleep, on cardiac structure, function, and long-term outcomes is not known. The aim of this study was to assess the effect of frequent leg movement during sleep on cardiac structure and outcomes in patients with restless legs syndrome. Methods: In our retrospective study, patients with restless legs syndrome referred for polysomnography were divided into those with frequent (periodic movement index > 35/hour) and infrequent (≤35/hour) leg movement during sleep. Long-term outcomes were determined using Kaplan-Meier and logistic regression models. Results: Of 584 patients, 47% had a periodic movement index > 35/hour. Despite similarly preserved left ventricular ejection fraction, the group with periodic movement index > 35/hour had significantly higher left ventricular mass and mass index, reflective of left ventricular hypertrophy (LVH). There were no significant baseline differences in the proportion of patients with hypertension, diabetes, hyperlipidemia, prior myocardial infarction, stroke or heart failure, or the use of antihypertensive medications between the groups. Patients with frequent periodic movement index were older, predominantly male, and had more prevalent coronary artery disease and atrial fibrillation. However, on multivariate analysis, periodic movement index > 35/hour remained the strongest predictor of LVH (odds ratio, 2.45; 95% confidence interval, 1.67-3.59; P <.001). Advanced age, female sex, and apnea-hypopnea index were other predictors of LVH. Patients with periodic movement index > 35/hour had significantly higher rates of heart failure and mortality over median 33-month follow-up. Conclusions: Frequent periodic leg movement during sleep is an independent predictor of severe LVH and is associated with increased cardiovascular morbidity and mortality.

Original languageEnglish (US)
Pages (from-to)783-790
Number of pages8
JournalJournal of the American Society of Echocardiography
Volume26
Issue number7
DOIs
StatePublished - Jul 2013

Fingerprint

Left Ventricular Hypertrophy
Leg
Sleep
Restless Legs Syndrome
Heart Failure
Logistic Models
Mortality
Polysomnography
Obstructive Sleep Apnea
Hyperlipidemias
Stroke Volume
Atrial Fibrillation
Antihypertensive Agents
Coronary Artery Disease
Multivariate Analysis
Retrospective Studies
Stroke
Odds Ratio
Myocardial Infarction
Confidence Intervals

Keywords

  • Left ventricular hypertrophy
  • Periodic limb movement disorder
  • Restless legs syndrome
  • Sleep
  • Sleep apnea

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Frequent periodic leg movement during sleep is associated with left ventricular hypertrophy and adverse cardiovascular outcomes. / Mirza, Mahek; Shen, Win Kuang; Sofi, Aamir; Jehangir, Ahad; Mori, Naoyo; Tajik, A. Jamil; Jahangir, Arshad.

In: Journal of the American Society of Echocardiography, Vol. 26, No. 7, 07.2013, p. 783-790.

Research output: Contribution to journalArticle

Mirza, Mahek ; Shen, Win Kuang ; Sofi, Aamir ; Jehangir, Ahad ; Mori, Naoyo ; Tajik, A. Jamil ; Jahangir, Arshad. / Frequent periodic leg movement during sleep is associated with left ventricular hypertrophy and adverse cardiovascular outcomes. In: Journal of the American Society of Echocardiography. 2013 ; Vol. 26, No. 7. pp. 783-790.
@article{96a0430945474bf8811fe14cb93b1c1a,
title = "Frequent periodic leg movement during sleep is associated with left ventricular hypertrophy and adverse cardiovascular outcomes",
abstract = "Background: Sleep disturbance caused by obstructive sleep apnea is recognized as a contributing factor to adverse cardiovascular outcomes. However, the effect of restless legs syndrome, another common cause of fragmented sleep, on cardiac structure, function, and long-term outcomes is not known. The aim of this study was to assess the effect of frequent leg movement during sleep on cardiac structure and outcomes in patients with restless legs syndrome. Methods: In our retrospective study, patients with restless legs syndrome referred for polysomnography were divided into those with frequent (periodic movement index > 35/hour) and infrequent (≤35/hour) leg movement during sleep. Long-term outcomes were determined using Kaplan-Meier and logistic regression models. Results: Of 584 patients, 47{\%} had a periodic movement index > 35/hour. Despite similarly preserved left ventricular ejection fraction, the group with periodic movement index > 35/hour had significantly higher left ventricular mass and mass index, reflective of left ventricular hypertrophy (LVH). There were no significant baseline differences in the proportion of patients with hypertension, diabetes, hyperlipidemia, prior myocardial infarction, stroke or heart failure, or the use of antihypertensive medications between the groups. Patients with frequent periodic movement index were older, predominantly male, and had more prevalent coronary artery disease and atrial fibrillation. However, on multivariate analysis, periodic movement index > 35/hour remained the strongest predictor of LVH (odds ratio, 2.45; 95{\%} confidence interval, 1.67-3.59; P <.001). Advanced age, female sex, and apnea-hypopnea index were other predictors of LVH. Patients with periodic movement index > 35/hour had significantly higher rates of heart failure and mortality over median 33-month follow-up. Conclusions: Frequent periodic leg movement during sleep is an independent predictor of severe LVH and is associated with increased cardiovascular morbidity and mortality.",
keywords = "Left ventricular hypertrophy, Periodic limb movement disorder, Restless legs syndrome, Sleep, Sleep apnea",
author = "Mahek Mirza and Shen, {Win Kuang} and Aamir Sofi and Ahad Jehangir and Naoyo Mori and Tajik, {A. Jamil} and Arshad Jahangir",
year = "2013",
month = "7",
doi = "10.1016/j.echo.2013.03.018",
language = "English (US)",
volume = "26",
pages = "783--790",
journal = "Journal of the American Society of Echocardiography",
issn = "0894-7317",
publisher = "Mosby Inc.",
number = "7",

}

TY - JOUR

T1 - Frequent periodic leg movement during sleep is associated with left ventricular hypertrophy and adverse cardiovascular outcomes

AU - Mirza, Mahek

AU - Shen, Win Kuang

AU - Sofi, Aamir

AU - Jehangir, Ahad

AU - Mori, Naoyo

AU - Tajik, A. Jamil

AU - Jahangir, Arshad

PY - 2013/7

Y1 - 2013/7

N2 - Background: Sleep disturbance caused by obstructive sleep apnea is recognized as a contributing factor to adverse cardiovascular outcomes. However, the effect of restless legs syndrome, another common cause of fragmented sleep, on cardiac structure, function, and long-term outcomes is not known. The aim of this study was to assess the effect of frequent leg movement during sleep on cardiac structure and outcomes in patients with restless legs syndrome. Methods: In our retrospective study, patients with restless legs syndrome referred for polysomnography were divided into those with frequent (periodic movement index > 35/hour) and infrequent (≤35/hour) leg movement during sleep. Long-term outcomes were determined using Kaplan-Meier and logistic regression models. Results: Of 584 patients, 47% had a periodic movement index > 35/hour. Despite similarly preserved left ventricular ejection fraction, the group with periodic movement index > 35/hour had significantly higher left ventricular mass and mass index, reflective of left ventricular hypertrophy (LVH). There were no significant baseline differences in the proportion of patients with hypertension, diabetes, hyperlipidemia, prior myocardial infarction, stroke or heart failure, or the use of antihypertensive medications between the groups. Patients with frequent periodic movement index were older, predominantly male, and had more prevalent coronary artery disease and atrial fibrillation. However, on multivariate analysis, periodic movement index > 35/hour remained the strongest predictor of LVH (odds ratio, 2.45; 95% confidence interval, 1.67-3.59; P <.001). Advanced age, female sex, and apnea-hypopnea index were other predictors of LVH. Patients with periodic movement index > 35/hour had significantly higher rates of heart failure and mortality over median 33-month follow-up. Conclusions: Frequent periodic leg movement during sleep is an independent predictor of severe LVH and is associated with increased cardiovascular morbidity and mortality.

AB - Background: Sleep disturbance caused by obstructive sleep apnea is recognized as a contributing factor to adverse cardiovascular outcomes. However, the effect of restless legs syndrome, another common cause of fragmented sleep, on cardiac structure, function, and long-term outcomes is not known. The aim of this study was to assess the effect of frequent leg movement during sleep on cardiac structure and outcomes in patients with restless legs syndrome. Methods: In our retrospective study, patients with restless legs syndrome referred for polysomnography were divided into those with frequent (periodic movement index > 35/hour) and infrequent (≤35/hour) leg movement during sleep. Long-term outcomes were determined using Kaplan-Meier and logistic regression models. Results: Of 584 patients, 47% had a periodic movement index > 35/hour. Despite similarly preserved left ventricular ejection fraction, the group with periodic movement index > 35/hour had significantly higher left ventricular mass and mass index, reflective of left ventricular hypertrophy (LVH). There were no significant baseline differences in the proportion of patients with hypertension, diabetes, hyperlipidemia, prior myocardial infarction, stroke or heart failure, or the use of antihypertensive medications between the groups. Patients with frequent periodic movement index were older, predominantly male, and had more prevalent coronary artery disease and atrial fibrillation. However, on multivariate analysis, periodic movement index > 35/hour remained the strongest predictor of LVH (odds ratio, 2.45; 95% confidence interval, 1.67-3.59; P <.001). Advanced age, female sex, and apnea-hypopnea index were other predictors of LVH. Patients with periodic movement index > 35/hour had significantly higher rates of heart failure and mortality over median 33-month follow-up. Conclusions: Frequent periodic leg movement during sleep is an independent predictor of severe LVH and is associated with increased cardiovascular morbidity and mortality.

KW - Left ventricular hypertrophy

KW - Periodic limb movement disorder

KW - Restless legs syndrome

KW - Sleep

KW - Sleep apnea

UR - http://www.scopus.com/inward/record.url?scp=84879413267&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84879413267&partnerID=8YFLogxK

U2 - 10.1016/j.echo.2013.03.018

DO - 10.1016/j.echo.2013.03.018

M3 - Article

C2 - 23622883

AN - SCOPUS:84879413267

VL - 26

SP - 783

EP - 790

JO - Journal of the American Society of Echocardiography

JF - Journal of the American Society of Echocardiography

SN - 0894-7317

IS - 7

ER -