Echocardiographic evaluation may provide more accurate patient selection for polysomnography in patients with obstructive sleep apnea: Predicting the severity of disease by echocardiography

Abstract

Aim: Obstructive sleep apnea (OSA) may influence the cardiac function by several mechanisms. The aim of the present study was to evaluate the impact of OSA on left and right cardiac function and determine the echocardiographic parameters which can help to predict the severity of OSA. Methods: In this cross-sectional analysis, 60 patients with suspected OSA were evaluated with transthoracic echocardiography before polysomnography between January and June 2017. On the basis of apnea-hypopnea index (AHI), the patients were classified into non-severe (AHI<30) (n = 30) and severe (AHI≥30) OSA (n = 30). The correlation between echocardiographic parameters and the apnea-hypopnea index (AHI) / Epworth Sleepiness Scale (ESS) was assessed.Results: Regarding left ventricular (LV) echocardiographic parameters: left ventricular outflow (LVOT) proximal diameter, left ventricular mass index, posterior wall enddiastolic diameter (PWEDD) and interventricular septum enddiastolic diameter (IVSEDD) were significantly higher in severe OSA patients. With respect to right ventricular (RV) functional parameters: RV fractional area change (RVFAC) and myocardial performance index (MPI) values were significantly higher in severe OSA patients. We found significant positive correlations between AHI and LVOT proximal diameter, IVSEDD, RVMPI, RV E and A velocities, body mass index, neck circumference and ESS. By using the model created with ‘PWEDD, LVOT diameter and RV A velocity’ we were able to predict most of the patients’ group correctly before polysomnography.Conclusion: We conclude that we can predict the severity of the disease in patients with suspected OSA by using echocardiography.

Keywords

• obstrucitive sleep apnea,
• echocardiography,
• polysomnography,
• ekokardiyografi,
• tıkayıcı uyku apnesi,
• polisomnogrefi,