A Novel Method for Sensitive Determination of Subclinical Left-Ventricular Systolic Dysfunction in Subjects With Obstructive Sleep Apnea

Zhou, Nan; Shu, Xianhong; Liu, Yili; Shen, Hong; Li, Wenjing; Gong, Xue; Chen, Haiyan; Zhao, Weipeng; Pan, Cuizhen; Li, Shanqun

doi:10.4187/respcare.04381

Cited by 17 publications

(18 citation statements)

References 28 publications

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“…LV-S' wave velocity is an indirect marker of ventricular systolic function. Two studies found no significant difference regarding LV-S' wave velocity among patients with OSA and controls [11, 15], consistent with the controversial reports regarding LV-EF in OSA.…”

Section: Introductionsupporting

confidence: 81%

“…Left ventricular posterior wall (LVPW) thickness, interventricular septum (IVS) thickness, and left ventricular mass (LVM) are reportedly higher in patients with severe OSA than in patients with moderate and mild OSA [9, 16]. Zhou et al also found a significant difference regarding IVS thickness in subjects with severe and moderate OSA versus controls ( p =0.001, p =0.002, respectively) [15]. The LVM index is significantly higher in subjects with severe OSA than in controls [7, 9], but no statistically significant changes in LV end-systolic and end-diastolic diameters were reported [8, 9].…”

Section: Introductionmentioning

confidence: 99%

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Review of Echocardiographic Findings in Patients with Obstructive Sleep Apnea

Sascău

Zota

Stătescu

et al. 2018

Canadian Respiratory Journal

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Obstructive sleep apnea (OSA) causes recurrent apneas due to upper respiratory tract collapse, leading to sympathetic nervous system hyperactivation and increased cardiovascular risk. Moderate and severe forms of obstructive sleep apnea are associated with increased atrial volumes and affect left ventricular diastolic and then systolic function. Right ventricular ejection fraction can be accurately assessed via three-dimensional echocardiography, while bidimensional imaging can only provide a set of surrogate parameters to characterize systolic function (tricuspid annulus plane systolic excursion, right ventricular fractional area change, and lateral S'). Tissue Doppler imaging is a more sensitive tool in detecting functional ventricular impairment, but its use is limited by angle dependence and the unwanted influence of tethering forces. Two-dimensional speckle tracking echocardiography is considered more suitable for the assessment of ventricular function, as it is able to distinguish between active and passive wall motion. Abnormal strain values, a marker of subclinical myocardial dysfunction, can be detected even in patients with normal ejection fraction and chamber volumes. The left ventricular longitudinal strain is more affected by the presence of obstructive sleep apnea than circumferential strain values. Although the observed OSA-induced changes are subtle, the benefit of a detailed echocardiographic screening for subclinical heart failure in OSA patients on therapy adherence and outcome should be addressed by further studies.

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Section: Introductionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Review of Echocardiographic Findings in Patients with Obstructive Sleep Apnea

Sascău

Zota

Stătescu

et al. 2018

Canadian Respiratory Journal

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show abstract

“…The findings showed that longitudinal strain was reduced in all myocardial layers in all cardiac segments (basal, mid, and apical) in patients with severe OSA compared with controls or mild OSA. 10 Circumferential strain in all three layers was lower in patients with OSA than in controls, but there was no difference between mild, moderate, and severe OSA patients. There was a strong correlation between AHI and multilayer strain (endo-, mid-, and epicardial).…”

mentioning

confidence: 83%

“…However, strain rates referring to LV mechanics during early and late diastole also gradually deteriorated from mild to severe OSA in all three directions-longitudinal, circumferential, and radial. 8 10 Circumferential strain in all three layers was lower in patients with OSA than in controls, but there was no difference between mild, moderate, and severe OSA patients. 6 On the other hand, there was no correlation between AHI and LV ejection fraction and only weak correlation with LV mass index.…”

mentioning

confidence: 83%

Obstructive sleep apnea and left ventricular strain: Useful tool or fancy gadget?

Cuspidi

Tadić

2019

J of Clinical Hypertension

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Obstructive sleep apnea (OSA) syndrome is the most common sleep-breathing disorder, which is characterized with snoring, interruptions in breading during sleeping, or daytime sleepiness, and choking or gasping during sleep. Polysomnography defined OSA as 5 or more episodes of obstructive apneas/hypopneas per hour during sleep. 1,2 There are many risk factors for OSA, but the most important is obesity, and therefore, many studies are devoted to the assessment of the influence of weight reduction in OSA. 3 It is also known that OSA increases risk of resistant arterial hypertension, coronary artery disease, heart failure, pulmonary hypertension, and various cardiovascular conditions. 4 Moreover, investigations demonstrated the association between OSA and cardiac remodeling. However, these studies were usually concentrated on left ventricular (LV) structure and function, which mainly included basic echocardiographic parameters such as LV hypertrophy, LV ejection fraction, and several basic parameters of LV diastolic (dys)function. 5 Investigations regarding LV mechanics in patients with OSA are scarce.Altekin et al 6 included 58 OSA patients with different severity of OSA. Patients were classified as mild OSA when the apnea-hypopnea index (AHI) was between 5 and 15, moderate OSA was diagnosed in patients with AHI between 15 and 30 and severe OSA was defined as AHI higher than 30. 6 The authors reported that main parameters of LV diastolic function (E/A, E/e′, mitral deceleration time, left atrial volume index) deteriorated gradually from mild to severe OSA. 6 More interestingly, the authors found gradual reduction in LV longitudinal strain from mild, across moderate, to severe OSA. The reduction in LV circumferential and radial strain was revealed in moderate and severe OSA patients, but not in those with mild OSA. However, strain rates referring to LV mechanics during early and late diastole also gradually deteriorated from mild to severe OSA in all three directions-longitudinal, circumferential, and radial. 6 The correlation between AHI and LV longitudinal strain and strain rates was significantly stronger than between AHI and parameters of LV diastolic function. 6 On the other hand, there was no correlation between AHI and LV ejection fraction and only weak correlation with LV mass index. 6 One should underline that there was no significant difference in body mass index (BMI) between three observed groups. However, the authors did not perform multivariate regression analysis including BMI in the model in order to exclude potential effect of obesity on the final results. Varghese et al 7 also reported significantly lower LV longitudinal strain in patients with severe OSA, but without significant difference in LV circumferential strain. LV longitudinal strain, but not circumferential strain, was found to correlate significantly with AHI. 7 Cho et al 8 included 25 patients with OSA and compared LV remodeling in these patients with healthy controls and obese patients, as well as the impact of bariatric surgery in pati...

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“…4 Je známo, že OSA je asociován s vyšší mortalitou a morbiditou z kardiovaskulárních příčin, pacienti mají častěji hypertenzi, poruchy srdečního rytmu, srdeční selhání nebo infarkt myokardu. [5][6][7][8][9][10][11][12][13] V České republice není prevalence OSA v celkové populaci dosud známa.…”

Section: úVodunclassified

(Using questionnaires to detect obstructive sleep apnoe)

Šulc¹

2020

Cor Vasa

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A Novel Method for Sensitive Determination of Subclinical Left-Ventricular Systolic Dysfunction in Subjects With Obstructive Sleep Apnea

Cited by 17 publications

References 28 publications

Review of Echocardiographic Findings in Patients with Obstructive Sleep Apnea

Review of Echocardiographic Findings in Patients with Obstructive Sleep Apnea

Obstructive sleep apnea and left ventricular strain: Useful tool or fancy gadget?

(Using questionnaires to detect obstructive sleep apnoe)

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