Abstract

Obstructive sleep apnea syndrome (OSAS) is a highly prevalent sleep disorder associated with increased cardiovascular morbidity and mortality. This study aimed to investigate heart structure and function and their correlation with the degree of OSAS and sleep indexes in patients diagnosed with OSAS. A cohort of 77patients (48 males, aged 58.1 ± 11.0 years, body mass index [BMI] = 32.4 ± 6.2) admitted to the hospital due to suspected OSAS was examined using echocardiography and polysomnography. Patients with moderate-to-severe OSAS compared to patients without diagnosed OSAS or with mild OSAS had greater right ventricular outflow tract (RVOT) dimensions (32.6 ± 3.6 vs 30.9 ± 2.4 mm; p < 0.05), larger right atrial area (RAA; 21.1 ± 4.8 vs 17.2 ± 3.2 mm; p = 0.002), greater right ventricular mid-cavity diameter (RVD; 35.5 ± 7.0 vs 32.2 ± 4.7 mm; p = 0.02), and diminished tricuspid annular plane systolic excursion (TAPSE, 21.9 ± 4.5 vs 25.8 ± 4.4 mm; p = 0.04), while there were no significant differences in tissue doppler imaging (TDI) parameters (S' and E') and in valvular regurgitation gradient for both groups. Moreover, significantly greater RVOT dimensions (31.6 ± 2.6 vs 30.9 ± 3.0 mm, p = 0.04), RVD (39.3 ± 7.0 vs 32.7 ± 5.2 mm, p = 0.003), and RAA (21.4 ± 4.4 vs 18.1 ± 4.2 mm, p = 0.02) as well as reduction in TAPSE (20.9 ± 5.3 vs 25.0 ± 4.3 mm, p = 0.01) were observed in patients having ≥ 10 episodes of obstructive apnea (OA) per hour. In moderate-to-severe OSAS patients, right ventricular (RV) enlargement was observed together with RV dysfunction as measured by TAPSE. Examination using TDI is not superior to standard echocardiography for the detection of heart pathology in OSAS patients. Right heart pathology is present predominantly in patients with obstructive apnea.

Highlights

  • Obstructive sleep apnea syndrome (OSAS) is a highly prevalent sleep disorder associated with increased cardiovascular morbidity and mortality

  • As current studies emphasize the influence of right ventricular (RV) function on outcomes, accurate RV assessment is essential in OSAS patients [7]

  • Obstructive sleep apnea syndrome has been linked to alterations in cardiac structure, but the pathophysiologic mechanisms between these cardiac abnormalities and OSAS are not completely understood [8]

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Summary

Introduction

Obstructive sleep apnea syndrome (OSAS) is a highly prevalent sleep disorder associated with increased cardiovascular morbidity and mortality. Obstructive sleep apnea syndrome (OSAS) is the most common type of sleep-related breathing disorder caused by repetitive airway collapse during sleep, affecting approximately 2–10% of the middle-aged global population [1, 2]. It is characterized by daytime sleepiness; serious complications such as hypertension, ischemic heart disease, diabetes, and stroke have been linked to OSAS [3,4,5,6]. Breathing disturbances may alter pulmonary circulation, resulting in the deterioration of right heart function and structure.

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