Sleep medicine · 2026
Association between right ventricular strain and subclinical left ventricular dysfunction in obstructive sleep apnea-hypopnea syndrome.
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Wu Jianbo, Huang Daqi, Cao Yunlong, Xue Xinyu, Zhu Xijun, Wang Xinyu, Liu Qian
Аннотация
OBJECTIVE: Using two-dimensional speckle-tracking echocardiography (2D-STE), this study analyzed biventricular strain changes in obstructive sleep apnea-hypopnea syndrome (OSAHS) and explored whether right ventricular (RV) dysfunction statistically mediates OSAHS-related left ventricular (LV) impairment.
METHODS: We enrolled 212 OSAHS patients and 52 controls, categorized by apnea-hypopnea index (AHI) into control (n = 52), mild-to-moderate (n = 80), and severe (n = 132) groups. We assessed 2D-STE-derived RV global longitudinal strain (RVGLS), RV free wall strain (RVFWS), and LV global longitudinal strain (LVGLS). Analyses included correlations, regressions, ROC curves, and mediation models.
RESULTS: RVGLS and RVFWS progressively became less negative with increasing OSAHS severity (P < 0.001), whereas LVGLS was significantly impaired only in severe OSAHS (P < 0.001). AHI correlated positively with RVGLS (r = 0.605), RVFWS (r = 0.583), and LVGLS (r = 0.302). RV strains showed good diagnostic value for severe OSAHS. Mediation analysis confirmed that RVGLS (β = 0.018, 95% CI: 0.007-0.029) and RVFWS (β = 0.013, 95% CI: 0.004-0.024) served as significant statistical mediators, which is statistically consistent with a mediating role in the AHI-LVGLS association.
CONCLUSION: Subclinical biventricular dysfunction occurs in OSAHS despite preserved LV ejection fraction. RV impairment is more sensitive to OSAHS severity than LV impairment and statistically mediates the AHI-LVGLS relationship. Routine 2D-STE RV strain assessment may facilitate early high-risk patient identification.
METHODS: We enrolled 212 OSAHS patients and 52 controls, categorized by apnea-hypopnea index (AHI) into control (n = 52), mild-to-moderate (n = 80), and severe (n = 132) groups. We assessed 2D-STE-derived RV global longitudinal strain (RVGLS), RV free wall strain (RVFWS), and LV global longitudinal strain (LVGLS). Analyses included correlations, regressions, ROC curves, and mediation models.
RESULTS: RVGLS and RVFWS progressively became less negative with increasing OSAHS severity (P < 0.001), whereas LVGLS was significantly impaired only in severe OSAHS (P < 0.001). AHI correlated positively with RVGLS (r = 0.605), RVFWS (r = 0.583), and LVGLS (r = 0.302). RV strains showed good diagnostic value for severe OSAHS. Mediation analysis confirmed that RVGLS (β = 0.018, 95% CI: 0.007-0.029) and RVFWS (β = 0.013, 95% CI: 0.004-0.024) served as significant statistical mediators, which is statistically consistent with a mediating role in the AHI-LVGLS association.
CONCLUSION: Subclinical biventricular dysfunction occurs in OSAHS despite preserved LV ejection fraction. RV impairment is more sensitive to OSAHS severity than LV impairment and statistically mediates the AHI-LVGLS relationship. Routine 2D-STE RV strain assessment may facilitate early high-risk patient identification.