Sleep & breathing = Schlaf & AtmungMay 25, 2015

Hidden heart pumping problems linked to heart muscle changes in sleep apnea patients measured by 3D ultrasound

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Mar 29, 2026

Abstract

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.

Simplified

BACKGROUND: Previous studies have demonstrated that patients with obstructive sleep apnea (OSA) may develop left ventricular (LV) diastolic dysfunction. We aimed to study whether OSA patients have LV regional systolic dysfunction with myocardial deformation changes, despite a normal LV ejection fraction, using real-time 3D speckle-tracking echocardiography (Rt3D-STE).

METHODS: Seventy-eight patients with OSA and no comorbidities were studied. They were divided into the following three groups according to the apnea-hypopnea index (AHI): 5~15/h as group I (mild OSA, 26 cases), 15~30/h as group II (moderate OSA, 29 cases), and ≥30/h as group III (severe OSA, 23 cases). Thirty gender-age-matched normal subjects were included as controls. The parameters of LV diastolic function were acquired with traditional echocardiography. The LV myocardial deformation parameters were obtained, including the longitudinal (LS), circumferential (CS), radial (RS), and area (AS) strains, with Rt3D-STE.

RESULTS: LV global systolic function was normal in all patients, but diastolic function was impaired in groups II and III (E/E' was 9.6 ± 2.8 and 10.4 ± 2.5, respectively, p < 0.0001). The global LS and AS were significantly reduced in groups II and III compared with the controls and group I (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 %, respectively, p < 0.0001), but the global CS and RS were significantly reduced only in group III (17.3 ± 1.4 % and 43.1 ± 6.5 % vs 19.6 ± 1.6 % and 55.4 ± 4.0 %, respectively, <0.0001). The severity of OSA was significantly associated with the LV global AS value (r = -0.80, p < 0.0001), LS (r = -0.64, p < 0.0001), CS (r = -0.51, p < 0.0001), and RS (r = -0.62, p < 0.0001).

CONCLUSIONS: Patients with moderate and severe OSA tended to have both LV diastolic dysfunction and abnormalities in regional systolic function with myocardial deformation changes, in spite of the normal LV ejection fraction. Myocardial strains of the LV were negatively correlated with the AHI. Rt-3DST had important clinical significance in the early evaluation of cardiac dysfunction in OSA patients.

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Hidden heart pumping problems linked to heart muscle changes in sleep apnea patients measured by 3D ultrasound

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