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Open AccessArticle

Nocturnal Hypoxemia Impacts Right Ventricle Diastolic Function in Obstructive Sleep Apnea: A Retrospective Observational Study

1
Istituti Clinici Scientifici Maugeri IRCCS, Cardiac Rehabilitation of the Institute of Lumezzane, 25065 Lumezzane (BS), Italy
2
Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Lumezzane, 25065 Lumezzane (BS), Italy
3
Istituti Clinici Scientifici Maugeri IRCCS, Scientific Direction of the Institute of Lumezzane, 25065 Lumezzane (BS), Italy)
*
Author to whom correspondence should be addressed.
These two authors equally contributed to the work.
J. Clin. Med. 2020, 9(1), 162; https://doi.org/10.3390/jcm9010162
Received: 5 December 2019 / Revised: 24 December 2019 / Accepted: 3 January 2020 / Published: 7 January 2020
Obstructive sleep apnea (OSA), although a growing healthcare problem and documented risk factor for cardiovascular diseases, is still under-diagnosed in cardiac patients. To investigate the correlation between OSA and echocardiographic parameters of right ventricle diastolic (RVD) dysfunction, in particular trans-tricuspid E-wave deceleration time (EDT), we retrospectively analyzed data of 103 pure (comorbidity-free) OSA patients with comprehensive echocardiographic examination (ETT). Apnea/hypopnea index (AHI), oxygen desaturation index (ODI), mean nighttime oxyhemoglobin saturation (SpO2), time elapsed with SpO2 < 90% (T90) and mean peak desaturation of nocturnal events (Mdes, graded as mild, medium or severe) were compared with echocardiographic parameters. We found RVD dysfunction present in 58.3% of patients. Altered EDT correlated significantly with mean SpO2, T90, and Mdes (p < 0.01, all). Nocturnal desaturators had a significantly worse EDT than non-desaturators (p = 0.027) and a higher risk of prolonged EDT (odds ratio, OR = 2.86). EDT differed significantly according to Mdes severity (p = 0.005) with a higher risk of prolonged EDT in medium/severe vs. mild Mdes (OR = 3.44). EDT detected the presence of RVD dysfunction in 58.3% of our pure OSA patients. It correlated poorly with AHI severity but strongly with nocturnal desaturation severity, independently of age. This ETT marker may be useful for deciding appropriate diagnostic and therapeutic strategies.
Keywords: obstructive sleep apneas (OSAs); right ventricular diastolic dysfunction; nocturnal desaturation; rehabilitation obstructive sleep apneas (OSAs); right ventricular diastolic dysfunction; nocturnal desaturation; rehabilitation
MDPI and ACS Style

Scotti, C.; Porta, R.; Olivares, A.; Comini, L.; Cinelli, A.; Scalvini, S.; Vitacca, M. Nocturnal Hypoxemia Impacts Right Ventricle Diastolic Function in Obstructive Sleep Apnea: A Retrospective Observational Study. J. Clin. Med. 2020, 9, 162.

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