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Left and right ventricular function in obstructive sleep apnea patients: Echocardiographic speckle tracking strain analysis of CPAP therapy effects

Bouchra Lamia, Stéphanie Gelinotte, Florence Portier, Luis-Carlos Molano, Catherine Tardif, Antoine Cuvelier, Jean-François Muir
European Respiratory Journal 2012 40: P3820; DOI:
Bouchra Lamia
1Respiratory and Critical Care Department-EA 3830, Rouen University Hospital, Rouen, France
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Stéphanie Gelinotte
1Respiratory and Critical Care Department-EA 3830, Rouen University Hospital, Rouen, France
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Florence Portier
1Respiratory and Critical Care Department-EA 3830, Rouen University Hospital, Rouen, France
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Luis-Carlos Molano
1Respiratory and Critical Care Department-EA 3830, Rouen University Hospital, Rouen, France
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Catherine Tardif
1Respiratory and Critical Care Department-EA 3830, Rouen University Hospital, Rouen, France
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Antoine Cuvelier
1Respiratory and Critical Care Department-EA 3830, Rouen University Hospital, Rouen, France
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Jean-François Muir
1Respiratory and Critical Care Department-EA 3830, Rouen University Hospital, Rouen, France
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Abstract

Introduction

Obstructive sleep apnea is associated with right ventricular dysfunction including preload and afterload abnormalities. Right ventricular contractility remains difficult to assess due to the complex RV geometry. Echocardiographic speckle tracking strain provides a better understanding of regional contractility. We tested the hypothesis that RV dyssynchrony exists in OSA patients and can be reversed by CPAP therapy.

Methods

Prospective study including patients with a confirmed OSA diagnosis. Echocardiographic (TTE) measurements were obtained at baseline and after one month of CPAP therapy. We measured usual TTE parameters: left ventricular ejection fraction (LVEF), transmitral pulsed Doppler including E and A waves velocities, mitral Doppler tissue imaging. The speckle tracking analysis was used to generate 6 segmental RV strain curves. Time to peak strain was determined with dyssynchrony defined as the difference between earliest and latest segments. Global radial strain was calculated.

Results

36 patients (M: 69%,mean (SD) age 56(11) yrs, body mass index 35.11(7.38) kg/m-2, respiratory disturbance index 46(18)/h) were included. At baseline, 56% had high blood pressure, 22% had a chronic heart disease, with a normal LVEF: 61(8) %. Speckle tracking strain analysis showed RV dysfunction with a decreased RV global strain: 13.8(5.8) % and RV dyssynchrony: 174 (89) ms. After one month of CPAP, RV function was significantly improved and dyssynchrony was reversed: 125 (82) ms, p=0.03.

Conclusion

We observed RV dyssynchrony at baseline in OSA patients. RV dyssynchrony was improved after one month of CPAP therapy.

  • Circulation
  • Imaging
  • Monitoring
  • © 2012 ERS
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Left and right ventricular function in obstructive sleep apnea patients: Echocardiographic speckle tracking strain analysis of CPAP therapy effects
Bouchra Lamia, Stéphanie Gelinotte, Florence Portier, Luis-Carlos Molano, Catherine Tardif, Antoine Cuvelier, Jean-François Muir
European Respiratory Journal Sep 2012, 40 (Suppl 56) P3820;

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Left and right ventricular function in obstructive sleep apnea patients: Echocardiographic speckle tracking strain analysis of CPAP therapy effects
Bouchra Lamia, Stéphanie Gelinotte, Florence Portier, Luis-Carlos Molano, Catherine Tardif, Antoine Cuvelier, Jean-François Muir
European Respiratory Journal Sep 2012, 40 (Suppl 56) P3820;
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