Review of Echocardiographic Findings in Patients with Obstructive Sleep Apnea

Sascău, Radu Andy; Zota, Ioana Mădălina; Stătescu, Cristian; Boişteanu, Daniela; Roca, Mihai; Maștaleru, Alexandra; Constantin, Maria Magdalena; Vasilcu, Teodor Flaviu; Gavril, Radu Sebastian; Mitu, Florin

doi:10.1155/2018/1206217

Cited by 31 publications

(33 citation statements)

References 44 publications

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“…Several studies have evaluated the cardiac function in OSA patients and shown the association between the syndrome severity and the impairment of a LV systo-diastolic performance in patients with normal daytime pulmonary pressure and preserved ejection fraction [17,18,[30][31][32][33][34][35].…”

Section: Discussionmentioning

confidence: 99%

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Nocturnal Hypoxemia Impacts Right Ventricle Diastolic Function in Obstructive Sleep Apnea: A Retrospective Observational Study

Scotti

Porta

Olivares

et al. 2020

JCM

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Obstructive sleep apnea (OSA), although a growing healthcare problem and documented risk factor for cardiovascular diseases, is still under-diagnosed in cardiac patients. To investigate the correlation between OSA and echocardiographic parameters of right ventricle diastolic (RVD) dysfunction, in particular trans-tricuspid E-wave deceleration time (EDT), we retrospectively analyzed data of 103 pure (comorbidity-free) OSA patients with comprehensive echocardiographic examination (ETT). Apnea/hypopnea index (AHI), oxygen desaturation index (ODI), mean nighttime oxyhemoglobin saturation (SpO2), time elapsed with SpO2 < 90% (T90) and mean peak desaturation of nocturnal events (Mdes, graded as mild, medium or severe) were compared with echocardiographic parameters. We found RVD dysfunction present in 58.3% of patients. Altered EDT correlated significantly with mean SpO2, T90, and Mdes (p < 0.01, all). Nocturnal desaturators had a significantly worse EDT than non-desaturators (p = 0.027) and a higher risk of prolonged EDT (odds ratio, OR = 2.86). EDT differed significantly according to Mdes severity (p = 0.005) with a higher risk of prolonged EDT in medium/severe vs. mild Mdes (OR = 3.44). EDT detected the presence of RVD dysfunction in 58.3% of our pure OSA patients. It correlated poorly with AHI severity but strongly with nocturnal desaturation severity, independently of age. This ETT marker may be useful for deciding appropriate diagnostic and therapeutic strategies.

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Section: Discussionmentioning

confidence: 99%

“…Prevalence of PH of varying degrees in patients with OSA is judged to be close to 17% and implies a poor prognosis [13][14][15][16], depending on the OSA severity. However, the pulmonary artery pressure (PAP) assessment method, time of measurement, and other factors may influence this result [17].…”

Section: Introductionmentioning

confidence: 99%

Nocturnal Hypoxemia Impacts Right Ventricle Diastolic Function in Obstructive Sleep Apnea: A Retrospective Observational Study

Scotti

Porta

Olivares

et al. 2020

JCM

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“…Polysomnography defined OSA as 5 or more episodes of obstructive apneas/hypopneas per hour during sleep. 5 Investigations regarding LV mechanics in patients with OSA are scarce. 3 It is also known that OSA increases risk of resistant arterial hypertension, coronary artery disease, heart failure, pulmonary hypertension, and various cardiovascular conditions.…”

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confidence: 99%

“…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.…”

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confidence: 99%

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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“…RV diastolic dysfunction often occurs earlier than RV systolic dysfunction, dilation, and hypertrophy . Accurate assessment of RV diastolic dysfunction and early intervention may be clinically useful to delay the progression of right heart failure . But few studies are reported on RV diastolic function in patients with OSAS at present.…”

Section: Introductionmentioning

confidence: 99%

Right ventricular diastolic dysfunction in patients with obstructive sleep apnea syndrome

Lin

et al. 2020

Echocardiography

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Background and Objectives This study aimed to assess right ventricular (RV) diastolic dysfunction in patients with obstructive sleep apnea syndrome (OSAS) using velocity vector imaging (VVI) and to evaluate the application of VVI technology. Methods According to the apnea–hypopnea index (AHI), 69 patients with OSAS were divided into three groups: mild, moderate, and severe. A total of 35 cases of healthy subjects were enrolled as the control group. Digital images of apex four‐chamber views were acquired to measure the peak early diastolic strain rate (RV‐SRe), late diastolic strain rate(RV‐SRa), and RV‐SRe/RV‐SRa using VVI. Results RV‐SRe, RV‐Sra, and RV‐SRe/RV‐SRa were decreasing along with the disease severity. RV‐SRe, RV‐SRe/RV‐SRa in moderate and severe OSAS group showed lower than control and mild OSAS groups. RV‐SRa in severe OSAS group showed lower than control group. RV‐SRe had the best correlation with AHI than other parameters. Conclusions Right ventricular diastolic dysfunction starts before the development of heart failure and pulmonary hypertension in patients with OSAS. RV‐SRe was the parameter that may reflect subclinical myocardial dysfunction and can better reflect RV diastolic dysfunction.

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Review of Echocardiographic Findings in Patients with Obstructive Sleep Apnea

Cited by 31 publications

References 44 publications

Nocturnal Hypoxemia Impacts Right Ventricle Diastolic Function in Obstructive Sleep Apnea: A Retrospective Observational Study

Nocturnal Hypoxemia Impacts Right Ventricle Diastolic Function in Obstructive Sleep Apnea: A Retrospective Observational Study

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

Right ventricular diastolic dysfunction in patients with obstructive sleep apnea syndrome

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