Abstract
During the last two decades, many articles were published summarizing the consequences of the obstructive sleep-apnea syndrome (OSAS). Research in this area mostly focuses on sudden cardiovascular changes during apneic episodes.
Long-term adaptive changes in the cardiovascular system are important as well,however,no consensus in this area has been reached yet. Differing echocardiographic findings in OSAS can result from: 1.
Evaluation of patients with other concurrent diseases that by themselves lead to important echocardiographic changes. These lead to an erroneous conclusion that OSAS leads to significant echocardiographic findings. 2.
Inclusion of patients with only a mild form of OSAS or of patients already treated, where the opposite conclusion can be made - that OSAS has no influence on echocardiographic changes. The aim of this study was to echocardiographically examine 19 patients (18 males, 1 female) with OSAS, mean age 52 (46-57) years, mean weight 116 (103-129) kg, mean BMI 35.1 (25.7-50.7) kg/m2, mean blood pressure 132/84 (126-138/79-89) mm Hg and to find the possible deviations of echocardiographic parameters in a "pure" OSAS (T 90 > 30 %) without other diseases except obesity.
Complete transthoracic echocardiographic examinations (continual, pulse and colormodes) were performed usingToshibaPowerVision 2000. Results showed a mild and insignificant dilatation of the right atrium (38+-5 mm) in 21%, dilatation of the right ventricle in 10% and a mild diastolic dysfunction of the right ventricle in 42% of the patients.
Suspected pulmonary hypertension was observed in 63% of the patients, mild diastolic dysfunction of the left ventricle in 16% of the patients. All patients had normal ejection fraction of the left ventricle 59+-4%.
We can conclude that echocardiographic abnormalities in "pure" OSAS are mild and clinically insignificant. If more significant echocardiographic findings are present, these may result from other concurrent diseases.