Left ventricular function assessed with two-dimensional speckle tracking and three-dimensional echocardiography in patients with obstructive sleep apnea

Abstract

Objective: To investigate left ventricular function by two-dimensional (2D) speckle tracking and three-dimensional (3D) echocardiography in obstructive sleep apnea (OSA) patients. Subject and method: Patients who were diagnosed with OSA based on the results of full polysomnography and had apnea- hypopnea index values > 5 events/hour of sleep were included in the study. All patient underwent polysomnography recording. Comprehensive 2-dimensional echocardiography were performed to all subjects according to American Society of Echocardiography guidelines [5], followed by real-time 3D echocardiography. Result: From June 2021 to June 2022, there were 46 OSA patients were included in the study. Mean age of OSA patients 51.3 ± 11.7 years. Men 63% (29/46), women 37% (15/46). The apnea-hypopnea index, percentage of total sleep time with an oxygen saturation level < 90%, arousal index increased in OSA patients. E/E’ increased (12.6 ± 4.3), GLS mildly reduced (-16.5 ± 3.8%) while other echocardiographic parameters were in normal range. Results of ANOVA showed an increase in the following LA parameters on 3D echocardiography according to the levels of OSA severity: LV mass index, 3D maximum LA volume, 3D maximum LA volume index, E/E’ were significantly higher in the severe OSA group compared with the moderate OSA and the mild OSA (p<0.05 for all). There was a decrease in the E’ velocity and global longitudinal strain (GLS) (p<0.05 for all). Conclusion: In patients with obstructive sleep apnea, the severity of OSA was associated with lower E′ velocity, greater E/E′ ratio, larger 3D LV volume, greater LV mass index, and poorer left ventricular global longitudinal strain.