Background: Obstructive Sleep Apnea(OSA) has been reported as a predictor of left ventricle(LV) diastolic dysfunction and left atrium(LA) remodeling. The aim of this study is to evaluate the impact of OSA treatment with a Continuous Positive Airway Pressure device(CPAP) on the LA volume and function, as well as on the LV diastolic function.
Methods: 56 OSA patients were studied. All patients underwent Real-Time Three-Dimensional(RT3DE) and two-dimensional echocardiogram with tissue Doppler evaluation in order to estimate LA volumes, function, and LV diastolic performance. A total of 30 patients with an Apnea-Hypopnea Index greater than 20 were randomly selected to receive sham CPAP(n=15) or effective CPAP(n=15) for 24 weeks. They underwent echo examination on 3 different occasions: at baseline, after 12 weeks, and 24 weeks of CPAP or sham CPAP.
Results: In the effective CPAP group we observed the following changes from the baseline to the 24-week echo evaluation: A) a reduction in the E/E´ratio (10.3±1.9 to 7.9± 1.3, P=0.03); B) an increase in the LA passive emptying fraction (28.8%±11.9 to 46.8%± 9.3, p=0.01); and C) a reduction in the LA active emptying fraction (42.7 %±11.5 to 25.7±15.7, P<0.01). In the sham group, there were no changes from the baseline to the 24 week echo. We found a positive correlation between 24 week/baseline LA active emptying volume and 24 week/baseline E/E' ratios (r=0.40, p<0.05) and a negative correlation between 24 week/baseline LA passive emptying volume and 24 week/baseline E/E´ratios (r=-0.53, P<0.05). No significant changes were found on LA total emptying fraction.
Conclusion: CPAP improved LV diastolic function and LA passive emptying, but not LA structural variables in OSA patients.
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