Prognostic value of echocardiographic parameters of cardiac remodeling in patients with hypertension and obstructive sleep apnea

Objective. To study the prognostic value of echocardiographic parameters of early cardiac remodeling in patients with hypertension (HTN) and obstructive sleep apnea (OSA). Design and methods. The study included 59 men with HTN and OSA (with an apnea/hypopnea index > 15 per hour). At baseline, all patients underwent polysomnography and echocardiography with an additional assessment of the global longitudinal strain (GLS). At baseline and at 12-month follow-up, a 6-minute walk test was performed. After 12 months, the clinical course of the disease was assessed. The criteria for an unfavorable course were episodes of hospitalization, the development of acute coronary syndrome, cerebral stroke, paroxysmal atrial fibrillation, worsening of chronic heart failure with a transition to a higher NYHA functional class. Results. In groups with favorable and unfavorable clinical course, some baseline echocardiographic parameters differed significantly: interventricular septal thickness (p = 0,037), left ventricular myocardial mass index (LVMI) (p = 0,003), tricuspid annular plane systolic excursion (TAPSE) (p < 0.001), GLS (p = 0,019), peak tricuspid regurgitation (p = 0,027), left atrial volume index (p = 0,048). Regression analysis showed that baseline TAPSE and LVMI had predictive value for an unfavorable clinical course. Conclusions. Our results confirm that certain echocardiographic parameters, in particular, LVMI and TAPSE, are predictors of the development and progression of cardiovascular complications in OSA patients.