Left atrial remodelling may predict exercise capacity in obstructive sleep apnoea patients

Area of Science:

• Cardiology
• Sleep Medicine
• Exercise Physiology

Background:

• Diastolic dysfunction (DD) is common in obstructive sleep apnea (OSA).
• Left atrial volume (LAV) and deformation are potential markers for exercise performance in DD.
• The study investigates the impact of LAV and LA deformation on exercise capacity across varying OSA severities.

Purpose of the Study:

• To evaluate the influence of left atrial volume (LAV) and left atrial (LA) deformation parameters on exercise performance in patients with obstructive sleep apnea (OSA).
• To assess the relationship between OSA severity, LA remodeling, and exercise capacity.

Main Methods:

• Fifty-five OSA patients were categorized by apnea-hypopnea index (AHI).
• Left atrial volume (LAV), LA strain, and LA strain rates were measured using speckle tracking echocardiography (STE).
• Exercise capacity was assessed via treadmill tests, with METs as the primary outcome.

Main Results:

• Patients with higher AHI (Group II) exhibited lower MET values compared to Group I (p < .05).
• Severe OSA (Group II) showed impaired LA strain, reduced LA strain rates, and increased E/E' and LAVI compared to mild OSA (Group I) (p < .05).
• Negative correlations were found between AHI, LVEDV, E/E', LAVI, and METs, while LA strain positively correlated with METs (p < .05).

Conclusions:

• Left ventricular diastolic dysfunction is more prevalent in severe OSA and is associated with impaired exercise performance.
• Left atrial remodeling, assessed by LAV and LA strain, may serve as a predictor of exercise capacity in OSA patients.
• These findings highlight the importance of cardiac assessment in managing OSA patients with exercise limitations.