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Background: Obstructive sleep apnea (OSA) is associated with right ventricular (RV) dysfunction and use of continuous positive airway pressure (CPAP) may improve RV function. 2D speckle tracking is a relatively new method for assessment of RV function and is believed to be more sensitive than traditional methods in detecting subclinical RV dysfunction. RV free wall strain is recently included in international guideline for RV function assessment. We compared RV function in subjects newly diagnosed with OSA at baseline, 4 weeks and 12 weeks after CPAP therapy, by using 2D speckle tracking and traditional methods.
Purpose: To investigate the effect of OSA on right ventricular function and changes after initiation of CPAP therapy.
Method: RV global and free wall longitudinal speckle tracking strain, TAPSE and RV fractional area change (FAC) were measured in 22 subjects (18 male, mean age 53+/-9) with newly diagnosed OSA (mean respiratory disturbance index (RDI) 29.8) after overnight polysomnography, and 1 month subsequently after initiation of CPAP therapy. The strain data was sent and analyzed blindly by experienced strain analysts.
Results: At baseline, the mean RV global strain and free wall strain were -23.0+/-3% and -26.6+/-4.2% respectively, with TAPSE 2.21+/-0.2mm and FAC 34.5+/-8%. At one month after CPAP therapy, there were statistically significant improvements in both RV global (-24.8+/-3.2%, relative change 7.83%, p=0.012) and RV free wall strain (-30.8+/-4.1%, relative change 15.8%, p<0.01). There were trends in improvement in TAPSE (2.24+/-2.9mm, p=0.54) and FAC (35.1+/-9.7%, p=0.83). At 12 weeks, there were insignificant change of RV global (-22.4+/-3.2%, p=0.69), free wall strain (-27.6+/-4.6%, p=0.41), TAPSE (2.33+/-0.29cm p=0.20) and FAC (39.7+/-8.9, p=0.26) compared with baseline.
Conclusions: Use of CPAP therapy correlate with improvement in RV function in subjects with OSA. RV global and free wall longitudinal strain maybe more sensitive in detection in change in RV function than TAPSE and FAC.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Novel Echocardiographic Methods for Assessing Cardiac Function
Abstract Category: 28. Non Invasive Imaging: Echo
Presentation Number: 1120-229
- 2017 American College of Cardiology Foundation