Non Invasive Assessment Of Pulmonary Artery Stiffness And Right Ventricular Function In Patients With Obstructive Sleep Apnea

Elsayed, Doaa; Shah, Mahmoud; Al Zaki, Manar; El-damanhory, Ahmed Said; Abdelrashid, Mahmoud

doi:10.21608/zumj.2020.19799.1627

Non Invasive Assessment Of Pulmonary Artery Stiffness And Right Ventricular Function In Patients With Obstructive Sleep Apnea

Document Type : Original Article

Authors

¹ assisstant lecturer cardiology ,zagazig university

² Professor of cardiology ,faculty of medicine,zagazig university

³ professor of Cardiology ,zagazig university

⁴ Lecturer of Cardiovascular medicine Faculty of Medicine &ndash; Zagazig University, Egypt

⁵ lecturer of cardiology department ,zagazig university

10.21608/zumj.2020.19799.1627

Abstract

Aim: to evaluate pulmonary artery stiffness and right ventricular function to predict early RV impairment in obstructive sleep apnea (OSA). We also aimed to assess the use of anticoagulants in patients with elevated pulmonary artery pressure and OSA.
Patients and methods: this study was performed on one hundred cases with OSA who did polysomnography study detecting the complete cessation of respiration and hypoventilation episodes, then estimation of serum fibrinogen, platelets, hepatic and renal functions and blood sugar, conventional echocardiography to measure right ventricular ejection fraction (RVEF), tricuspid annular plane systolic excurtion (TAPSE), myocardial performance index (MPI), fractional area change (FAC), linear diameters of right ventricular inflow tract (RVOT), right ventricular (RV) free wall thickness, Doppler assessment of pulmonary artery stiffness (PAS) and speckle tracking echocardiography (STE) .
Results: There was a highly noticed difference among the study groups regarding Fibrinogen, platelet count, RVEF, TAPSE, GLS and PAS. There was a positive relation between fibrinogen and apnea-hypopna index (AHI) (r= 0.686, p < 0.001), a positive relation between PAS and AHI (r= 0.515, p < 0.001), a negative relation between RVEF and AHI (r= -0.639, p < 0.001) and a negative relation between GLS and AHI (r=-0.663, p < 0.001). We found that GLS was important with PAS for prediction of RV failure.
Conclusion: OSA patients may have a hidden RV systolic impairment detected by STE. PAS may contribute to the development of RV impairment. Elevated fibrinogen is important risk factor for cardiovascular pathology and may direct attention for starting anticoagulation in OSA patients.

Keywords