Supervisors info:
Εμμανουήλ Βαβουρανάκης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Γεράσιμος Σιάσος, Καθηγητής, Πρύτανης, Ιατρική Σχολή, ΕΚΠΑ
Κωνσταντίνος Τσιούφης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Summary:
This study delves into the intricate relationship between Central Sleep Apnea (CSA) and Obstructive Sleep Apnea (OSA) and their consequential impacts on diastolic function, a critical determinant of cardiac efficiency and health. Diastolic function, pivotal in cardiac output and blood pressure maintenance, becomes compromised in the presence of sleep-disordered breathing, with varying implications for CSA and OSA. Through a meticulous literature review, this research aimed to compare and contrast the echocardiographic characteristics of diastolic function between CSA and OSA patients, providing insights into the unique and shared cardiovascular manifestations of these conditions. CSA, often associated with neurohumoral imbalances in heart failure, and OSA, characterized by physical airway obstruction, exert distinct yet overlapping influences on cardiac structure and function. Our analysis revealed that CSA primarily impacts diastolic function through increased left atrial volume, suggesting atrial stress and potential exacerbation of heart failure with preserved ejection fraction (HFpEF). OSA, conversely, was found to induce significant ventricular remodeling, marked by increased left ventricular mass and diastolic dysfunction parameters, alongside right ventricular dysfunction in severe cases. These findings underscore the mechanistic differences in how CSA and OSA affect diastolic function, highlighting the role of recurrent hypoxemic episodes and intrathoracic pressure fluctuations inherent in OSA in driving myocardial stress and hypertrophy. The main conclusion drawn from this comparative analysis emphasizes the importance of recognizing and addressing both CSA and OSA in cardiac care to prevent the progression of diastolic dysfunction. Advanced echocardiographic techniques, including speckle tracking echocardiography, emerged as valuable tools in detecting early myocardial changes, suggesting their potential in enhancing the diagnostic and management strategies for patients with sleep-disordered breathing. This study underscores the need for integrated approaches in diagnosing and treating sleep apnea, highlighting echocardiography's pivotal role in identifying early cardiac involvement and guiding clinical interventions to mitigate cardiovascular risks associated with CSA and OSA
Keywords:
Diastolic Function, Echographic Characteristics, Central Sleep Apnea, Peripheral Sleep Apnea
