title: Assessment of Right Ventricular Function in Obstructive Sleep Apnea Syndrome and Effects of Continuous Positive Airway Pressure Therapy: A Pilot Study.
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.
authors.affiliation: Cardio-Respiratory Department, Sapienza University, Rome, Italy. Electronic address: vitar@tiscali.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Vitarelli
authors.affiliation: Cardio-Respiratory Department, Sapienza University, Rome, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Terzano
authors.affiliation: Otolaryngology Department, Sapienza University, Rome, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Saponara
authors.affiliation: Cardio-Respiratory Department, Sapienza University, Rome, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Gaudio
authors.affiliation: Cardio-Respiratory Department, Sapienza University, Rome, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Mangieri
authors.affiliation: Cardio-Respiratory Department, Sapienza University, Rome, Italy.
authors.forename: Lidia
authors.initials: L
authors.lastname: Capotosto
authors.affiliation: Medicine Department, Sapienza University, Rome, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Pergolini
authors.affiliation: Cardio-Respiratory Department, Sapienza University, Rome, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: D'Orazio
authors.affiliation: Cardio-Respiratory Department, Sapienza University, Rome, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Continanza
authors.affiliation: Cardio-Respiratory Department, Sapienza University, Rome, Italy.
authors.forename: Ester
authors.initials: E
authors.lastname: Cimino
mesh_terms: D045422:Continuous Positive Airway Pressure / Q000379:methods*; D019560:Echocardiography, Three-Dimensional; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D017286:Polysomnography; D012372:ROC Curve; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D013318:Stroke Volume / Q000502:physiology; D013599:Systole; D016278:Ventricular Function, Right / Q000502:physiology*