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Impact of Continuous Positive Airway Pressure Treatment on Left Atrial Volume and Function in Patients with Obstructive Sleep Apnea Assessed by Real-Time Three-Dimensional Echocardiography
  1. Wercules Oliveira (wercules.oliveira{at}yahoo.com.br)
  1. UNIFESP, Brazil
    1. Orlando Campos
    1. UNIFESP, Brazil
      1. Fatima Cintra
      1. UNIFESP, Brazil
        1. Livia Nascimento Matos
        1. UNIFESP, Brazil
          1. Marcelo LC Vieira
          1. Hospital Israelita Albert Einstein, Brazil
            1. Barbara Rollim
            1. UNIFESP, Brazil
              1. Luciane Fujita
              1. UNIFESP, Brazil
                1. Sergio Tufik
                1. UNIFESP, Brazil
                  1. Dalva Poyares (poyares{at}psicobio.epm.br)
                  1. UNIFESP, Brazil

                    Abstract

                    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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