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 (? = -0.28, P?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 Sep

REPOSITORIES: biostudies-literature