Key result
In OSAHS patients with HFpEF, the presence of atrial fibrillation was associated with significantly increased right heart structural abnormalities, mainly in the right atrium, and cardiac remodeling worsened with OSAHS severity.
Why the study?
To explore cardiac structural and functional changes in OSAHS patients with HFpEF and AF.
Observational (n=336)
No
In patients with OSAHS and HFpEF, the presence of atrial fibrillation is associated with significant right heart structural remodeling, particularly right atrial enlargement, rather than left heart structural changes.
AF in OSAHS-HFpEF was associated with right atrial enlargement; hypothesis-generating for remodeling effects, prospective studies needed before practice change.
OBJECTIVE: To explore the cardiac structural and functional changes in obstructive sleep apnea-hypopnea syndrome (OSAHS) patients with heart failure with preserved ejection fraction (HFpEF) and atrial fibrillation (AF). METHODS: This retrospective study included 336 OSAHS patients with HFpEF. They were divided into Groups A (without an AF history and no AF episodes during cardiac color ultrasound examination), B (an AF history but no AF episodes), and C (an AF history and AF episodes). They all received cardiac color ultrasound examinations. Cardiac structural and functional changes in ultrasonic cardiograms were compared between the three groups. RESULTS: Compared with Groups A and B, Group C showed increased left atrial diameter (LAD), left atrial volume (LAV), right ventricular diameter at end-diastole (RV-D1), right ventricular diameter at end-systole (RV-D2), right ventricular outflow tract diameter (RVOT2), right atrial diameter at end-diastole (RA-D1), right atrial diameter at end-systole (RA-D2), and right atrial area (RAA) (p < 0.05). Compared with Group A, Group C showed decreased fractional shortening (FS), left ventricular ejection fraction (LVEF), deceleration time (DT), isovolumic relaxation time (IVRT), E/E' ratio, and peak filling velocity (FPV), as well as increased E and E' (p < 0.01). Compared with Group B, Group C showed decreased FS and increased E and FPV (p < 0.01). CONCLUSION: In OSAHS patients with HFpEF and AF, cardiac remodeling and AF incidence are increased with the severity of OSAHS. OSAHS patients with HFpEF combined with AF have a significantly higher abnormality rate in right heart structural indices rather than left heart, mainly in the right atrium.
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Luo et al. (2024) conducted an observational in Obstructive sleep apnea-hypopnea syndrome (OSAHS) with heart failure with preserved ejection fraction (HFpEF) (n=336). Atrial fibrillation vs. No atrial fibrillation was evaluated on Cardiac structural and functional changes (including LAD, LAV, RV-D1, RV-D2, RVOT2, RA-D1, RA-D2, RAA) (p=<0.05). In OSAHS patients with HFpEF, the presence of atrial fibrillation was associated with significantly increased right heart structural abnormalities, mainly in the right atrium, and cardiac remodeling worsened with OSAHS severity.
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