Assessment of left atrial dysfunction in obstructive sleep apnea patients with the two dimensional speckle-tracking echocardiography.
BACKGROUND
The aim of this study was to compare left atrial (LA) longutidinal myocardial function in obstructive sleep apnea (OSA) patients with healthy individuals using two-dimensional speckle-tracking echocardiography method (2D-STE).


METHODS
Twenty one healthy individuals and 58 OSA patients were included. According to the AHI (apnea hypopnea index) patients were examined in mild, moderate and severe OSA groups. Images of the LA were acquired from the apical two- and four-chamber views. LA strain(LA(S)) and strain rate(LA(SR)) parameters [systolic (S), early diastolic (E), late diastolic (A) during atrial contraction] were assessed.


RESULTS
LA(S-S), LA(SR-S), LA(S-E) and LA(SR-E) values decreased with severity of OSA. Severe OSA patients have lower LA(S-S) and LA(SR-S) values (p < 0.03). While a difference in the LA(SR-E) value between groups was significant beginning with the moderate OSA group (p < 0.03), no LA(S-E) value differences were observed between moderate and mild OSA groups (p > 0.03). LA(S-A) and LA(SR-A) values were increasing with the disease severity up to moderate OSA. LA(S-A) and LA(SR-A) values of moderate OSA were greater than the mild OSA patients and healthy individuals (p < 0.03). These were lower in severe OSA than the moderate OSA (p < 0.03), however, they were greater than the healthy individuals (p < 0.03). The AHI was found to be negatively correlated with the LA(S-S), LA(SR-S) LA(S-E), LA(SR-E), whereas AHI was not correlated with the LA(S-A), LA(SR-A) values.


CONCLUSIONS
LA remodeling and dysfunction that accompany OSA can be detected in the subclinical stage with a detailed evaluation of active and passive functions of the LA using the 2D-STE method.
Department of Cardiology, Faculty of Medicine, Akdeniz University, Dumlupinar Bouleward, Konyaalti, 07070 Antalya, Turkey. dremre29@yahoo.com
Refik Emre
RE
Altekin
Atakan
A
Yanikoglu
Mustafa Serkan
MS
Karakas
Deniz
D
Ozel
Murathan
M
Kucuk
Huseyin
H
Yilmaz
Ibrahim
I
Demir
D000328:Adult; D016279:Atrial Function, Left; D016022:Case-Control Studies; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000000981:diagnostic imaging* / Q000503:physiopathology