title: A novel method for sensitive determination of subclinical right ventricular systolic dysfunction in patients with obstructive sleep apnea.
abstract: OBJECTIVE
  The aim of this study was to evaluate right ventricular (RV) regional systolic function and dyssynchrony in patients with newly diagnosed obstructive sleep apnea using real-time three-dimensional (3D) echocardiography.
  
  
  METHODS
  Eighty-two subjects without hypertension, diabetes mellitus or any cardiac or pulmonary disease referred for evaluation of obstructive sleep apnea (OSA) had overnight polysomnography and complete echocardiographic assessment. According to the apnea hypopnea index (AHI), subjects were divided into four groups: group 1: control subjects (AHI < 5, n = 19), group 2: patients with mild OSA (AHI: 5-14, n = 21), group 3: moderate OSA (AHI: 15-30, n = 18), group 4: severe OSA (AHI > 30, n = 24). Real-time three-dimensional echocardiographic images were acquired to obtain RV regional (inflow, body and outflow) ejection fraction (EF) and time to minimum systolic volume in all subjects.
  
  
  RESULTS
  Body weight and body mass index were greater in the severe and moderate OSA group than those of mild and controls group (P < 0.05). There was a significant decrease in mean SaO2 and the lowest SaO2 in severe OSA when compared to other groups (P < 0.001). Inflow EF and global EF were significantly lower in moderate and severe OSA patients than in controls (P < 0.05). Inflow EF and global EF were negatively correlated with AHI (r = -0.534 and r = -0.479, respectively, P < 0.001).
  
  
  CONCLUSIONS
  In patients with OSA, RV inflow and global systolic function were impaired and were in inverse relationship with AHI. Evaluation of RV regional systolic function using real-time three-dimensional echocardiography may play a potential role in the noninvasive assessment of the severity of OSA.
authors.affiliation: Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: Nian-Wei
authors.initials: NW
authors.lastname: Zhou
authors.affiliation: Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: Cui-Zhen
authors.initials: CZ
authors.lastname: Pan
authors.affiliation: Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: De-Hong
authors.initials: DH
authors.lastname: Kong
authors.affiliation: Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Wen-Jing
authors.initials: WJ
authors.lastname: Li
authors.affiliation: Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: Xue
authors.initials: X
authors.lastname: Gong
authors.affiliation: Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: Hai-Yan
authors.initials: HY
authors.lastname: Chen
authors.affiliation: Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: Wei-Peng
authors.initials: WP
authors.lastname: Zhao
authors.affiliation: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: Xiao-Lin
authors.initials: XL
authors.lastname: Wang
authors.affiliation: Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Shan-Qun
authors.initials: SQ
authors.lastname: Li
authors.affiliation: Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: Xian-Hong
authors.initials: XH
authors.lastname: Shu
mesh_terms: D000328:Adult; D000368:Aged; D001795:Blood Pressure Determination / Q000379:methods; D015992:Body Mass Index; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography / Q000295:instrumentation; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D013318:Stroke Volume / Q000502:physiology*; D013599:Systole; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000503:physiopathology
keywords: obstructive sleep apnea; right ventricular; three-dimensional echocardiography