Abstract
NIV therapy of OSAS has been shown to improve left ventricular (LV) systolic dysfunction, also due to a reduction in LV afterload and causes a regression of LV hypertrophy. However, the effect of NIV on the patterns of right heart function and geometry are less well known.
The aim of the study was to analyze the different involvement of right heart function in patients with OSAS treated with NIV by the use of 2D-STE, a novel approach to provides accurate information about segmental myocardial deformation during the cardiac cycle.
We enrolled 20 subject with OSAS. Exclusion criteria were coronary disease, valvular heart disease, congestive heart failure, cardiomyopathies. All the patients underwent sleeping NIV for at least 12 hours. Echocardiogram was made pre- and during NIV.
Inferior Caval Vein both inspiration and expiration was higher during ventilation (p<0,005 and p<0,007 respectively). PAPs was impaired during ventilation (p<0,01). E-peak velocity were mildly increased during NIV (p<0,01). Regional peak myocardial right ventricular strain were significantly impaired in patient during NIV (p<0,005). Moreover, right atrium lateral wall strain were significantly impaired in patients during NIV (p<0,001).
The study demonstrates that a novel speckle-tracking algorithm represent a promising non-invasive technique to assess RV myocardial function in patients with OSAS during NIV and also highlights the worsering of the function of the right heart during NIV, probably due to the increase of afterload. This suggests to carefully assess the myocardial function before starting NIV in patients with high suspect of the right heart impairment.
- Copyright ©ERS 2015