Prospective echocardiographic study of right and left cardiac function during sleep in obstructive sleep apnea syndrome: Assessment at 1 month and 6 months of treatment with CPAP

Abstract

Introduction

OSA is associated with a cardiac dysfunction.The aim of our study was 1 - to analyze usual transthoracic echocardiography (TTE) indices of left and right ventricle (LV , RV) and more recent indices as regional contractility and torsion of LV by speckle tracking strain 2 - Describe the effects of CPAP treatment at 1 month and 6 months on cardiac function.

Design

Thirty-six patients were prospectively included. TTE with speckle tracking strain analysis of contractility and LV torsion was performed at baseline, one month and 6 months of CPAP treatment.

Results

Respiratory disturbance index was 46±16/h. One month of CPAP therapy had no effect on LV ejection fraction (61±8 vs 63±6%, p=0,13) or regional contractility (134±85 vs 135±96 msec). Only RV regional contractility was improved (174±89 vs 127±81, p=0,01) and LV diastolic function was affected (7,1±1,7 vs 8,0±2,2 p=0,01). Six months of CPAP therapy induced significant improvement of RV regional contractility (174±89 vs119±56 p=0.01), ticuspid regurgitation pressure gradient (22±7 vs 21±5 p=0,01) and LV torsion (11±5 vs 14±4 degrés, p<0,05).

Conclusion:

OSA is associated with abnormalities of global contractility of RV and LV and LV twist measured by speckle tracking strain. Right ventricular afterload is also affected. One to 6 months of CPAP therapy may improve these abnormalities.