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Effect of obstructive sleep apnea on right ventricular ejection fraction in patients with hypertrophic obstructive cardiomyopathy.


ABSTRACT:

Background

Obstructive sleep apnea (OSA) is a common disease associated with worse structural and functional impairment of the heart in patients with hypertrophic obstructive cardiomyopathy (HOCM).

Hypothesis

The presence and severity of OSA can decrease the right ventricular ejection fraction (RVEF) in patients with HOCM.

Methods

In total, 151 consecutive patients with a confirmed diagnosis of HOCM at Fuwai Hospital between September 2017 and September 2018 were included. Polysomnography and cardiac magnetic resonance imaging were performed in all patients.

Results

Overall, 84 (55.6%) patients were diagnosed with OSA. The RVEF significantly decreased with the severity of OSA (none, mild, moderate-severe: 46.1 ± 8.2 vs 42.9 ± 7.5 vs 41.4 ± 7.4, P = .009). The apnea-hypopnea index (AHI) was significantly high in patients with RVEF<40% among the different OSA groups (mild, moderate:7.7 ± 2.4 vs 9.6 ± 2.9, P = .03; 24.4 ± 9.0 vs 36.3 ± 18.0, P = .01). In the multiple linear regression model, the right ventricular end-systolic volume (β = -0.28, P < .001), AHI (β = -0.09, P = .02), and oxygen desaturation index (β = -0.11, P = .04) were independently associated with a decrease in RVEF (adjusted R2 = 0.347, P < .001). Furthermore, the prevalence of RVEF<40% was high in patients with OSA. Compared with RVEF>40%, RVEF<40% was associated with more symptoms, mainly chest pain, chest distress, NYHA class III or IV, pulmonary hypertension, and moderate or severe mitral regurgitation.

Conclusion

In patients with HOCM, the presence and severity of OSA is independently associated with a lower RVEF. In addition, compared with patients with RVEF>40%, those with RVEF<40% had more symptoms, including chest pain, chest distress, and NYHA class III or IV.

SUBMITTER: Wang S 

PROVIDER: S-EPMC7534009 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Effect of obstructive sleep apnea on right ventricular ejection fraction in patients with hypertrophic obstructive cardiomyopathy.

Wang Shengwei S   Cui Hao H   Ji Keshan K   Ren Changwei C   Guo Hongchang H   Zhu Changsheng C   Lai Yongqiang Y   Wang Shuiyun S  

Clinical cardiology 20200916 10


<h4>Background</h4>Obstructive sleep apnea (OSA) is a common disease associated with worse structural and functional impairment of the heart in patients with hypertrophic obstructive cardiomyopathy (HOCM).<h4>Hypothesis</h4>The presence and severity of OSA can decrease the right ventricular ejection fraction (RVEF) in patients with HOCM.<h4>Methods</h4>In total, 151 consecutive patients with a confirmed diagnosis of HOCM at Fuwai Hospital between September 2017 and September 2018 were included.  ...[more]

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