Evaluation of right ventricular systolic and diastolic function in patients with newly diagnosed obstructive sleep apnea syndrome without hypertension.
OBJECTIVE
We investigated right ventricular (RV) structural and functional cardiac alterations in obstructive sleep apnea (OSA) independent of systemic hypertension and their correlation to the severity of OSA.


METHODS
Forty-one moderate-to-severe OSA but otherwise healthy patients and 30 body mass index-matched control subjects were included. All subjects underwent 24-hour ambulatory blood pressure monitoring, standard and tissue Doppler imaging of the RV.


RESULTS
The OSA group had increased RV wall thickness, impaired right ventricular outflow tract fractional shortening (RVOT fs), tricuspid annular plane systolic excursion (TAPSE), RV myocardial performance index (MPI) and RV myocardial acceleration during isovolumic contraction (IVA) (p < 0.001). Apnea hypopnea index (AHI) and mean pulmonary artery (PA) pressure were correlated with all these indices (p < 0.01 for all). RV free wall thickness (p < 0.001) and IVA (p = 0.006) remained significant predictors of AHI after adjusting for age, body mass index, mean PA pressure, RVOT fs, TAPSE and MPI in a multiple stepwise linear regression model.


CONCLUSIONS
OSA is associated with impaired RV function despite normal systemic blood pressures. The level of RV dysfunction has a direct relationship with the severity of OSA. RV free wall thickness and IVA are independent predictors of AHI in uncomplicated OSA patients.
Tugcu
Aylin
A
Division of Cardiology, Florence Nightingale Hospital, Abide-i Hurriyet cad. No:290, Caglayan, Istanbul, Turkey.
Guzel
Deniz
D
Yildirimturk
Ozlem
O
Aytekin
Saide
S
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D015992:Body Mass Index; D003971:Diastole; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011237:Predictive Value of Tests; D011669:Pulmonary Wedge Pressure; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000175:diagnosis; D013599:Systole; D018497:Ventricular Dysfunction, Right / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D016278:Ventricular Function, Right