The Relationship Between Obstructive Sleep Apnea Severity and Right Heart Cavities Echocardiographic Features

Abstract

Aim: Obstructive sleep apnea (OSA) has been attributed to an increased risk of cardiovascular disease and death from all causes. It has been demonstrated that OSA affects the right ventricle’s (RV) diastolic and systolic functioning, with diastolic dysfunction usually appearing before systolic failure. Delaying the progression of right ventricular failure may be clinically beneficial if RV diastolic insufficiency is accurately assessed and treated early. This study aimed to investigate right ventricular diastolic function in patients with OSA and its relationship with disease severity. Material and Method: The study comprised 88 participants with an OSA diagnosis who had transthoracic echocardiography. Based on their apnea and hypopnea index, the individuals were split into two groups as mild-moderate OSA (mild; apnea and hypopnea index 5–14 events/hour, moderate; apnea and hypopnea index 15–29 events/hour) and severe OSA (apnea and hypopnea index ≥30 events/hour). Results: The severe group consisted of forty-three people, whereas the mild-to-moderate group had forty-five. The right atrial volume index (RAVI) (13.26±4.81 mL/m² vs. 24.24±10.75 mL/ m2; p <0.001) and E/Em tricuspid ratio (5.70±2.32 vs. 7.21±3.83; p=0.046) of the severe group were substantially higher than those of the mild-moderate group. Conclusion: The severity of OSA can be accurately predicted using the echocardiographic measures RAVI and tricuspid E/Em, which are practical, affordable, and easily available.

Keywords

• obstructive sleep apnea
• right ventricular diastolic dysfunction
• right atrial volume index

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