Left ventricular subclinical dysfunction associated with myocardial deformation changes in obstructive sleep apnea patients estimated by real-time 3D speckle-tracking echocardiography

Patients with moderate and severe obstructive sleep apnea (OSA) exhibited significant reductions in left ventricular (LV) myocardial strains despite normal ejection fractions.

• Diastolic function was impaired in patients with moderate (AHI 15-30/h) and severe (AHI ≥30/h) OSA, with E/E' values of 9.6 ± 2.8 and 10.4 ± 2.5, respectively.
• Global longitudinal strain (LS) and area strain (AS) were significantly lower in moderate and severe OSA groups compared to controls and mild OSA (LS: 15.9 ± 1.4 % and 14.8 ± 1.5 % vs 18.2 ± 1.7 % and 17.8 ± 1.5 %; AS: 27.4 ± 1.8 % and 24.9 ± 2.3 % vs 33.4 ± 2.2 % and 32.7 ± 2.9 %, p < 0.0001).
• Global circumferential strain (CS) and radial strain (RS) were significantly reduced only in the severe OSA group (CS: 17.3 ± 1.4 % vs 19.6 ± 1.6 %; RS: 43.1 ± 6.5 % vs 55.4 ± 4.0 %, p < 0.0001).
• The severity of OSA was negatively correlated with global AS (r = -0.80), LS (r = -0.64), CS (r = -0.51), and RS (r = -0.62), all with p < 0.0001.
• Real-time 3D speckle-tracking echocardiography may be valuable for early detection of cardiac dysfunction in OSA patients.

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