The Function of the Right Ventricle and the Incidence of Pulmonary Hypertension in Patients with Obstructive Sleep Apnoea Syndrome

Czech version

Authors: E. Sovová ¹; M. Hobzová ²; J. Zapletalová ³; V. Kolek ²; J. Lukl ¹
Authors‘ workplace: Ústav lékařské biofyziky LF UP Olomouc ¹; I. interní klinika LF UP a FN Olomouc ¹; Klinika plicních nemocí a tuberkulózy LF UP a FN Olomouc ²
Published in: Cesk Slov Neurol N 2008; 71/104(3): 293-297
Category: Original Paper

Overview

The objective of the study was to evaluate the overall function of the right ventricle (RV) and to determine the incidence of pulmonary hypertension (PH) in patients diagnosed with moderate or severe obstructive sleep apnoea (OSA).

Set of patients and methods:
75 patients (of which 65 men) with an average age of 52.3 ± and OSA diagnosis were screened by an GE VIVID 7 echocardiograph (RV size, pulmonary artery acceleration time, pulmonary valve and tricuspidal valve regurgitation, the measurement of RV pressure and of RV systolic and diastolic speed using tissue Doppler echocardiography, and the determination of the TEI index of global RV function). The A group with moderate OSA consisted of 17 patients (of which 15 men) aged 54.6 ± 9.2 years, with body mass index (BMI) 33.6 ± 6.3 and oxygen (O₂) saturation at rest prior to examination (the ASTRUP method) 94.0 ± 2.4 %. The B group of patients with severe OSA consisted of 58 patients (of which 50 men) aged 51.7 ± 10.3 years, with BMI 35.1 ± 5.9 and O₂ saturation at rest prior to examination (the ASTRUP method) 93.0 ± 3.2 %. Other causes of pulmonary hypertension were excluded in the patients.

Results:
The A and B groups did not differ in terms of sex (p = 0.829), age (p = 0.283), arterial hypertension incidence (p = 0.741), BMI (p = 0.387), O₂ saturation at rest prior to examination (the ASTRUP method) (p = 0.158), or average O₂ saturation during sleep monitoring (p = 0.130). Pulmonary hypertension (pulmonary artery pressure over 30 mm Hg) was diagnosed in 5 patients (5 men), i.e. 6.6 %, the average value of systolic pressure being 34.8 mm Hg (32-37). All patients belonged in the B group. The value of the RV global function TEI index was pathological in 31 patients (41.3 %) of which 2 (11.7 %) were of the A and 29 (50 %) of the B group, respectively. There was a statistically significant difference between the groups in terms of the number of patients with a pathological value of the RV global function TEI index (p = 0.016). The average value of the global RV function TEI index was 0.31 ± 0.23 in the set, with 0.19 ± 0.13 in group A and 0.35 ± 0.24 in group B. There was a statistically significant difference in the values of the global RV function TEI index between groups A and B, its value being lower in group A (better right ventricle global function in the group with moderate OSA) (p = 0.011).

Conclusion:
The incidence of PH in patients with OSA is low. Patients with OSA are most often diagnosed with RV diastolic function disorder. Patients with severe OSA have worse results for global RV function determined with the use of the global RV function TEI index.

Key words:
obstructive sleep apnoea – pulmonary hypertension – global RV function TEI index

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