Clinical ResearchAssessment of Right Ventricular Function in Obstructive Sleep Apnea Syndrome and Effects of Continuous Positive Airway Pressure Therapy: A Pilot Study
Section snippets
Methods
For detailed methodological information and statistical analysis, see the Methods section of the Supplementary Material.
A cohort of 37 sleep apnea patients without comorbidities and 30 control subjects were examined with polysomnography15 and echocardiography. Established echocardiographic criteria were used for assessment of right chambers.16, 17, 18, 19, 20, 21, 22, 23 Three-dimensional echocardiographic images (Fig. 1) were stored digitally for off-line analysis using dedicated software. STE
Results
Thirty-seven of 44 initially evaluated OSAS patients were included in the study. 3DE images of the right ventricle were successfully analyzed in 41 of 44 patients. Longitudinal 2D RV strain measurement from all segments because of adequate tracking quality was possible in 42 of 44 patients. 3-D feasibility was 93%, and 2D strain feasibility was 95%. Tricuspid regurgitation to estimate right-sided pressure was found in 37 of 44 patients (84%). The intraobserver and interobserver reproducibility
Discussion
The results of the present study are as follows: (1) overall in patients with OSAS, RV longitudinal strain and 3-D RVEF decreased and volumes increased in parallel with changes in segmental dyssynchrony in the presence and absence of PH; (2) RV dyssynchrony and 3-D RVEF had a greater association with OSAS severity compared with other echocardiographic indices of RV dysfunction; and (3) CPAP therapy tended to restore the uniformity of RV wall contraction with reduction of RV volumes.
Conclusions
Early impairment of RV mechanics in patients with isolated OSAS suggests that it is a response to overload caused by this disease independently of confounders. STE-determined RV dyssynchrony and 3-D volumes were the parameters most closely related with OSAS severity and ventricular subclinical dysfunction. CPAP therapy might prevent the progression of RV abnormalities and reverse these changes before severe structural alterations occur.
Disclosures
The authors have no conflicts of interest to disclose.
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