Obstructive Sleep Apnea and Sleep Structure Assessed in Polysomnography and Right Ventricular Strain Parameters

Abstract

Our study aimed to assess functional, structural changes of the right ventricular using strain parameters and sleep structure using polysomnography in patients with obstructive sleep apnea (OSA). Our study group consisted of 43 patients, 29 men, 14 women. The mean age was 56.36 ± 14.77. All patients underwent full night polysomnography and transthoracic echocardiography. The right ventricular global longitudinal strain was measured by 2D speckle-tracking echocardiography. The prevalence of OSA (AHI ≥ 5) was 76.7% in the studied group. We observed a significant positive correlation between OAH and average free wall strain (r = 0.37), snore and mid-free wall strain (r = 0.34), average HR, and basal free wall strain (r = 0.34). Moreover, CSB was positively correlated with basal septal strain and mid septal strain (r = 0.36 and 0.42). In summary, among patients with sleep disorders, functional disorders of the right ventricle, assessed using the strain method, are partly observed.

Obstructive sleep apnea and right ventricular function: A meta‐analysis of speckle tracking echocardiographic studies

“…Our meta-analysis showed that TAPSE was reduced in OSA patients compared with controls, but this parameter was not able to differentiate the progressive stages of OSA syndrome. It should be pointed out, however, that the majority of studies included in this meta-analysis failed to find any difference in TAPSE, s' or fractional area change (FAC) between OSA patients and controls [22][23][24][25][26][27][28] and only Altekin and coworkers found that TAPSE was significantly worsened in patients with moderate and severe OSA compared to controls.…”

“…The first literature screening identified a total of 711 papers. After the initial search of titles and abstracts, 661 papers were excluded and 50 were reviewed; of these, eight studies 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 fulfilled the inclusion criteria and comprised sufficient data to be enclosed in the present meta‐analysis (Figure S1 ).…”

Obstructive Sleep Apnea and Right Ventricular Remodeling: Do We Have All the Answers?

“…Investigations mostly agree about reduced RV GLS and free-wall LS in OSA patients [ 13 , 17 , 23 , 26 , 27 , 30 , 31 , 33 ], and most of them speculate about higher sensitivity to recognize subclinical RV damage in patients with preserved parameters of RV systolic function ( Table 2 ). Additionally, authors reported significant difference in RV longitudinal strain values between patients with various OSA severity [ 23 , 30 ], which also contributes to the claims that strain is more sensitive to subtle myocardial changes.…”

“…Some authors went so far as to investigate RV segmental changes in OSA patients, and interestingly found no difference in RV basal and apical free-wall LS, even though average free-wall RVLS was significantly lower in OSA patients [ 33 ]. All septal segments showed significantly lower LS in OSA patients, but septum is also part of the left ventricle, and it is difficult to distinguish OSA influence on the left and right ventricle separately.…”

“…The most extensive gradual deterioration was detected in apical RVLS. Interestingly, the investigators did not find any difference in TAPSE, s’, or the myocardial performance index between OSA and control subjects or patients with different levels of OSA severity [ 27 , 33 ]. The investigation that used velocity vector imaging revealed a significant reduction in RV longitudinal strain and strain rate of free-wall basal, mid, and apical segments [ 30 ].…”