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    Assessment of left atrial dysfunction in obstructive sleep apnea patients with the two dimensional speckle-tracking echocardiography
    (2012) Altekin R.E.; Yanikoglu A.; Karakas M.S.; Ozel D.; Kucuk M.; Yilmaz H.; Demir I.
    Background The aim of this study was to compare left atrial (LA) longutidinal myocardial function in obstructive sleep apnea (OSA) patients with healthy individuals using two-dimensional speckle-tracking echocardiography method (2D-STE). Method Twenty one healthy individuals and 58 OSA patients were included. According to the AHI (apnea hypopnea index) patients were examined in mild, moderate and severe OSA groups. Images of the LA were acquired from the apical two- and four-chamber views. LA strain (LAS) and strain rate(LASR) parameters [systolic (S), early diastolic (E), late diastolic (A) during atrial contraction] were assessed. Results LA S-S, LASR-S, LAS-E and LASR-E values decreased with severity of OSA. Severe OSA patients have lower LAS-S and LASR-S values (p < 0.03).While a difference in the LA SR-E value between groups was significant beginning with the moderate OSA group (p < 0.03), no LAS-E value differences were observed between moderate and mild OSA groups (p > 0.03). LAS-A and LA SR-A values were increasing with the disease severity up to moderate OSA. LAS-A and LASR-A values of moderate OSA were greater than the mild OSA patients and healthy individuals (p < 0.03). Thesewere lower in severe OSA than the moderate OSA (p < 0.03), however, theywere greater than the healthy individuals (p < 0.03). The AHI was found to be negatively correlated with the LAS-S, LASR-S LA S-E, LASR-E, whereas AHI was not correlated with the LAS-A, LASR-A values. Conclusion LA remodeling and dysfunction that accompany OSA can be detected in the subclinical stage with a detailed evaluation of active and passive functions of the LA using the 2D-STE method. © Springer-Verlag 2012.