Evaluation of Pulmonary Artery Stiffness in Patients with Obstructive Sleep Apnea Syndrome

Altıparmak, İbrahim Halil; Erkuş, Muslihittin Emre; Polat, Mustafa; Sak, Zafer Hasan Ali; Yalçın, Funda; Günebakmaz, Özgür; Sezen, Yusuf; Kaya, Zekeriya; Demirbağ, Recep

doi:10.1111/echo.13098

Cited by 18 publications

(34 citation statements)

References 32 publications

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“…However, heterogeneity is to be expected given the variety of studies conducted by different teams at various geographic locations, the variation in disease severity, and differences in the patient populations. In most studies, the investigators were blinded to the participants' study group status [15, 16, 21–27, 29, 31, 33–35, 38, 39]. In addition, interobserver agreement and intraobserver reproducibility were assessed in most of the studies [15, 16, 21, 23–25, 27, 29, 33, 36, 38, 39].…”

Section: Discussionmentioning

confidence: 99%

Right Ventricular Remodeling and Dysfunction in Obstructive Sleep Apnea: A Systematic Review of the Literature and Meta-Analysis

Maripov

Mamazhakypov

Sartmyrzaeva

et al. 2017

Canadian Respiratory Journal

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Background Recent studies have reported that obstructive sleep apnea (OSA) patients present alterations in right ventricular (RV) structure and function. However, large randomized controlled trials evaluating the impact of OSA on the right ventricle are lacking. Methods A comprehensive electronic database (PubMed, Web of Science, and Google Scholar) and reference search up to October 30, 2016, was performed. A systematic review and meta-analysis were performed to assess RV structure and function in OSA patients based on conventional echocardiography and tissue Doppler imaging. Results Twenty-five studies with 1,503 OSA patients and 796 controls were included in this study. OSA patients exhibited an increase in RV internal diameter (weighted mean difference (WMD) (95% confidence intervals (CIs)) 2.49 (1.62 to 3.37); p = 0.000) and RV wall thickness (WMD (95% CIs) 0.82 (0.51 to 1.13); p = 0.000). Furthermore, OSA patients had a significantly elevated RV myocardial performance index (WMD (95% CI) 0.08 (0.06 to 0.10); p = 0.000), decreased RV S' (WMD (95% CI) −0.95 (−1.59 to −0.32); p = 0.003), tricuspid annular plane systolic excursion (WMD (95% CI) −1.76 (−2.73 to −0.78); p = 0.000), and RV fractional area change (WMD (95% CI) −3.16 (−5.60 to −0.73); p = 0.011). Conclusion OSA patients display RV dilatation, increased wall thickening, and altered RV function.

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Section: Discussionmentioning

confidence: 99%

Right Ventricular Remodeling and Dysfunction in Obstructive Sleep Apnea: A Systematic Review of the Literature and Meta-Analysis

Maripov

Mamazhakypov

Sartmyrzaeva

et al. 2017

Canadian Respiratory Journal

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“…Similar findings obtained for the aorta in OSAS patients were also reported for the pulmonary vascular bed. In patients with OSAS, Altıparmak et al revealed significantly impaired pulmonary artery distensibility that was also positively correlated with AHI (19).…”

Section: Discussionmentioning

confidence: 99%

“…The pulmonary artery elasticity is an important factor governing this relationship, with increased stiffness leading to higher right ventricular pulsatile work load, decreased contractile performance, and enhanced energy transmission to smaller pulmonary vessels, resulting in further vascular damage (23)(24)(25). A recent study by Altıparmak et al demonstrated also that pulmonary artery distensibility is associated with right ventricular systolic and diastolic parameters (19). They used right ventricular MPI, which is a global parameter of cardiac function combining both systole and diastole.…”

Section: Discussionmentioning

confidence: 99%

Obstructive sleep apnea syndrome is associated with impaired pulmonary artery distensibility and right ventricular systolic dysfunction

2018

Turk J Med Sci

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“…20 Although the relationship between them has not been fully explained, it was reported that the increase in PAS is an important factor contributing to RV afterload and eventual RV failure. [8][9][10][11][12][13][14] In this population, pulmonary diseases affecting the right heart, especially OSAS and COPD, may cause right heart dysfunction without PHT. [8][9][10][11][12][13][14] In this population, pulmonary diseases affecting the right heart, especially OSAS and COPD, may cause right heart dysfunction without PHT.…”

Section: Pas Is a Relatively New Doppler Echocardiographic Parametermentioning

confidence: 99%

“…[8][9][10][11][12][13][14] There is a limited number of studies on cardiovascular complications of asthma. In primary bronchopulmonary diseases, hypoxia-induced changes may cause PAS to increase by triggering remodeling in the pulmonary vascular structure.…”

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confidence: 99%

Evaluation of pulmonary artery stiffness in newly diagnosed adult patients with asthma

Baysal

Has

2019

Echocardiography

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Background There are limited studies on the effects of asthma on cardiac function. Right ventricular dysfunction and pulmonary hypertension are cardiovascular complications that may be seen in advanced stages of the disease. Pulmonary artery stiffness (PAS), is a promising, relatively new echocardiographic index that has been reported to increase in right ventricular failure, providing information about pulmonary vascular bed. Aim In this study, we aimed to evaluate PAS, a marker of pulmonary artery elasticity, in adult‐onset asthma. Methods Ninety‐nine nonsmokers who had a new asthma diagnosis between the ages of 18 and 65 years and 97 healthy controls with similar age and sex distribution were included in the study. PAS was calculated by dividing the maximal frequency shift of pulmonary flow (MFS) in pulmonary acceleration time (PAT). Results Clinical and demographic characteristics of both groups were similar (P ˃ 0.05). PAS values were higher in the asthma group than in the control group (25.2 ± 4.5 vs 22.4 ± 4.1, P ˂0.001). TAPSE was lower in the case group (24.9 ± 2.0 vs 25.5 ± 2.1, P = 0.043), while RV MPI was higher (0.36 ± 0.07 vs 0.32 ± 0.06, P ˂0.001). In the multivariate linear regression analysis, RV MPI, RV Em, and TAPSE variables were independent predictors of PAS. Conclusion In our study, PAS values were higher in patients with newly diagnosed adult asthma and we found a significant weak correlation between PAS values and subclinical right ventricular dysfunction.

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Evaluation of Pulmonary Artery Stiffness in Patients with Obstructive Sleep Apnea Syndrome

Abstract: Elastic properties of pulmonary artery deteriorate with severity of OSAS and may be responsible for right ventricular dysfunctions in OSAS.

Cited by 18 publications

References 32 publications

Right Ventricular Remodeling and Dysfunction in Obstructive Sleep Apnea: A Systematic Review of the Literature and Meta-Analysis

Right Ventricular Remodeling and Dysfunction in Obstructive Sleep Apnea: A Systematic Review of the Literature and Meta-Analysis

Obstructive sleep apnea syndrome is associated with impaired pulmonary artery distensibility and right ventricular systolic dysfunction

Evaluation of pulmonary artery stiffness in newly diagnosed adult patients with asthma

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