Echocardiographic
abnormalities in obstructive sleep-apnea syndrome
Trefný M.1, Paleček T.2, Susa Z.2, Linhart A.2, Slavíček J.3, Trefný Z.3
1Plicní klinika 2. lékařské fakulty Univerzity Karlovy a FN Motol, Praha, 2II. interní klinika 1. lékařské fakulty Univerzity Karlovy, Praha, 3Fyziologický ústav 1. lékařské fakulty Univerzity Karlovy, Praha |
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Summary:
During the last two decades, many articles were published summarizing the consequences of the
obstructive sleep-apnea syndrome (OSAS). Research in this area mostly focuses on sudden cardiovascular
changes during apneic episodes. Long-term adaptive changes in the cardiovascular system are
important as well,however,no consensus in this area has been reached yet. Differing echocardiographic
findings in OSAS can result from: 1. Evaluation of patients with other concurrent diseases that by
themselves lead to important echocardiographic changes. These lead to an erroneous conclusion that
OSAS leads to significant echocardiographic findings. 2. Inclusion of patients with only a mild form of
OSAS or of patients already treated, where the opposite conclusion can be made – that OSAS has no
influence on echocardiographic changes. The aim of this study was to echocardiographically examine
19 patients (18 males, 1 female) with OSAS, mean age 52 (46–57) years, mean weight 116 (103–129) kg,
mean BMI 35.1 (25.7–50.7) kg/m2, mean blood pressure 132/84 (126–138/79–89) mm Hg and to find the
possible deviations of echocardiographic parameters in a „pure“ OSAS (T 90 > 30 %) without other
diseases except obesity. Complete transthoracic echocardiographic examinations (continual, pulse and
colormodes) were performed usingToshibaPowerVision 2000. Results showed a mild and insignificant
dilatation of the right atrium (38±5 mm) in 21%, dilatation of the right ventricle in 10% and a mild
diastolic dysfunction of the right ventricle in 42% of the patients. Suspected pulmonary hypertension
was observed in 63% of the patients, mild diastolic dysfunction of the left ventricle in 16% of the patients.
All patients had normal ejection fraction of the left ventricle 59±4%. We can conclude that echocardiographic
abnormalities in „pure“ OSAS are mild and clinically insignificant. If more significant
echocardiographic findings are present, these may result from other concurrent diseases.
Key words:
obstructive sleep-apnea syndrome, echocardiography, obesity
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