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Date Published: 16/02/2023
Online Published: 16/02/2023
Abstract Views: 153
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DOI: https://doi.org/10.55046/vjrnm.48.788.2022
Issue
No. 02 (2022): English
Section
Scientific research
How to Cite
Nguyen , T. T. H. (2023). Assessment of left atrial volume and function by real-time three-dimensional echocardiography in obstructive sleep apnea. Vietnamese Journal of Radiology and Nuclear Medicine, 02, 3-8. https://doi.org/10.55046/vjrnm.48.788.2022

Assessment of left atrial volume and function by real-time three-dimensional echocardiography in obstructive sleep apnea

Nguyen Thi Thu Hoai

Main Article Content

Abstract

Aims: To evaluate the volumetric and functional abnormalities of the left atrium (LA) using real-time three-dimensional echocardiography (RT3DE) in patients with obstructive sleep apnea (OSA) compared with a control group.


Methods: Patients with OSA and age-and sex-matched control subjects were recruited to the study in Bach Mai hospital. All patients underwent polysomnography recording. Comprehensive 2-dimensional echocardiographic (2DE) was performed to all subjects according to American Society of Echocardiography guidelines, followed by RT3DE. Maximum LA volume, maximum LA volume indexed for body surface area (BSA), minimum LA volume, and LA volume before contraction were obtained.


Results: From June 2021 to June 2022, there were 46 OSA patients and 30 controls were included in the study. Mean age of OSA patients 51.3 ± 11.7. Men accounted for 63% (29/46). The apnea-hypopnea index, percentage of total sleep time with an oxygen saturation level < 90%, arousal index were higher in OSA patients compared with controls. There was a significantly higher 2D LA volume index and E/E’ ratio in the OSA patients compared with the controls (p<0.05). RT3D echocardiography results showed a larger maximum LA volume indexed for BSA, LA volume before atrial contraction, total LA systolic volume, and active LA systolic volume and a higher active LA ejection fraction in the OSA patients compared with controls (p<0.05 for all). There was an increase in the following LA parameters on RT3DE according to the levels of OSA severity: 3D maximum LA volume, 3D maximum LA volume index, 3D LA volume before LA contraction; 3D LA total systolic volume, 3D LA active systolic volume, 3D LA active systolic ejection fraction (p<0.05). On the other hand, 2D maximum LA volume and 2D maximum LA volume index did not differ according to the severity of OSA (p>0.05)


Conclusion: There was a significant increase in LA volume and augmentation of LA active systolic function in patients with OSA. The severity of OSA was directly linked with the enlargement of 3D LA volume while this was not seen with 2D LA volume.

Article Details

Keywords

Left atrial volume, obstructive sleep apnea, echocardiography, three-dimensional echocardiography, left atrial enlargement.

References

1. Marin JM, Carrizo SJ, Vicente E, Agusti AG. Long-term cardiovascular outcomes in men with obstructive sleep apnea-hypopnea with or without treatment with continuous positive airway pressure: an observation study. Lancet 2005; 365:1046–1053
2. Young T, Finn L, Peppard PE, Szklo-Coxe M, Austin D, Nieto FJ, Stubbs R, Hla KM. Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort. Sleep 2008; 31: 1071–1078
3. Herrscher T, Akre H, Overland B, et al. High prevalence of sleep apnea in heart failure outpatients: even in patients with preserved systolic function. J Card Fail. 2011;17(5):420-425.
4. Kim SM, Cho KI, Kwon JH, Lee HG, Kim TI. Impact of obstructive sleep apnea on left atrial functional and structural remodeling beyond obesity. J Cardiol 2012; 60:475–483
5. Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imag. 2015;16:233-270.
6. Koka AR, Gould SD, Owen AN, Halpern EJ. Left atrial volume: comparison of 2D and 3D transthoracic echocardiography with ECG-gated CT angiography. Acad Radiol 2012 Jan;19(1):62-8.
7. Berry R. Fundamentals of Sleep Medicine, Elsevier Health Sciences. 2011;1st Edition
8. Douglas PS. The left atrium: a biomarker of chronic diastolic dysfunction and cardiovascular disease risk. J Am Coll Cardiol 2003; 42: 1206–1207
9. Tsang TS, Abhayaratna WP, Barnes ME, Miyasaka Y, Gersh BJ, Bailey KR, Cha SS, Seward JB. Prediction of cardiovascular outcomes with left atrial size. J Am Coll Cardiol 2006; 47:1018–1023 10. Otto ME, Belohlavek M, Romero-Corral A, Somers VK et al (2007). Comparison of Cardiac Structural and Functional Changes in Obese Otherwise Healthy Adults With Versus Without Obstructive Sleep Apnea. Am J Cardiol 2007;99:1298–1302
11. Usui Y, Takata Y, Inoue Y, Shimada K, Tomiyama H, Nishihata Y, Kato K, Shiina K, Yamashina A. Coexistence of obstructive sleep apnoea and metabolic syndrome is independently associated with left ventricular hypertrophy and diastolic dysfunction. Sleep Breath. 2012; 16:677–684
12. Fredgart MH, Carter-Storch R, Møller JE, Diederichsen ACP et al. Measurement of left atrial volume by 2D and 3D non-contrast computed tomography compared with cardiac magnetic resonance imaging. Int J Cardiovasc Imaging. 2018 Mar; 34(3):337-342. doi: 10.1007/s10554-017-1243-7