Abstract
Background
It is known that obstructive sleep apnea syndrome (OSAS) can affect right ventricular
(RV) performance even in the absence of systemic hypertension and other known cardiac
or obstructive pulmonary disease. The purpose of the present study was to assess RV
function in OSAS using 3-D echocardiography and speckle tracking echocardiography
(STE) and evaluate changes after continuous positive airway pressure (CPAP) treatment.
Methods
Thirty-seven patients with OSAS without comorbidities and thirty control subjects
were studied using 3-D echocardiography and STE. Fifteen patients underwent CPAP therapy
and were studied before and after treatment. RV 3-D ejection fraction was calculated.
Peak systolic strain was determined. RV dyssynchrony was defined as SD of the 6 time
to peak systolic strain values.
Results
3-D RV ejection fraction was lower and RV dyssynchrony was greater in patients with
moderate-severe OSAS compared with control subjects in the presence and absence of
pulmonary hypertension. 3-D RV ejection fraction and RV dyssynchrony were independently
associated with apnea-hypopnea index. Patients treated with CPAP had significant changes
in RV parameters.
Conclusions
3-D RV ejection fraction and RV dyssynchrony were abnormal in OSAS patients compared
with control subjects and associated with OSAS severity. RV 3-D STE abnormalities
improved after chronic application of CPAP.
Résumé
Introduction
On sait que le syndrome de l’apnée obstructive du sommeil (SAOS) peut affecter la
performance du ventricule droit (VD) même en l’absence d’hypertension systémique et
d’autres maladies cardiaques ou pulmonaires obstructives. Le but de la présente étude
était d’évaluer la fonction du VD lors du SAOS à l’aide de l’échocardiographie 3D
et de l’échocardiographie Speckle Tracking (suivi de pixel; EST) et les changements après le traitement par pression positive
expiratoire continue (CPAP).
Méthodes
Trente-sept patients souffrant du SAOS sans comorbidités et 30 sujets témoins ont
été étudiés à l’aide de l’échocardiographie 3D et de l’EST. Quinze patients ont subi
la thérapie CPAP et ont été étudiés avant et après le traitement. La fraction d’éjection
du VD en 3D a été calculée. La déformation systolique maximale a été déterminée. La
dyssynchronie du VD a été définie comme étant suérieure de 6 fois l'ET des valeurs
maximales de déformation systolique.
Résultats
La fraction d’éjection du VD en 3D était plus faible et la dyssynchronie du VD était
plus grande chez les patients souffrant du SAOS modéré à grave que chez les sujets
témoins en présence ou en l’absence d’hypertension pulmonaire. La fraction d’éjection
du VD en 3D et la dyssynchronie du VD étaient indépendamment associées à l’index d’apnées-hypopnées.
Les patients traités par CPAP montraient des changements significatifs dans les paramètres
du VD.
Conclusions
La fraction d’éjection du VD en 3D et la dyssynchronie du VD étaient anormales chez
les patients souffrant du SAOS comparativement aux sujets témoins et associées à la
gravité du SAOS. Les anomalies du VD en 3D à l’EST s’amélioraient après l’application
à long terme du CPAP.
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Article info
Publication history
Published online: January 28, 2015
Accepted:
January 25,
2015
Received:
December 3,
2014
Footnotes
See editorial by Raisinghani, et al., pages 821-822 of this issue.
See page 829 for disclosure information.
Identification
Copyright
© 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
