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  • Mohammed Al-Sadawi,
  • Kleanthis Theodoropoulos,
  • farzane saeidifard,
  • Adekunle Kiladejo,
  • Patricia Erwin,
  • Mohammad Al-Ajam,
  • Louis Salciccioli,
  • Adam Budzikowski
Mohammed Al-Sadawi
Stony Brook Medicine

Corresponding Author:[email protected]

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Kleanthis Theodoropoulos
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farzane saeidifard
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Adekunle Kiladejo
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Patricia Erwin
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Mohammad Al-Ajam
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Louis Salciccioli
SUNY Downstate Medical Center
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Adam Budzikowski
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Abstract: Background: This meta-analysis assessed the relationship between Obstructive Sleep Apnea (OSA) and echocardiographic parameters of diastolic dysfunction (DD), which are used in the assessment of Heart Failure with Preserved Ejection Fraction (HFpEF). Methods: We searched the databases including Ovid MEDLINE, Ovid Embase Scopus, Web of Science, Google Scholar, and EBSCO CINAHL from inception up to December 26th, 2020. The search was not restricted to time, publication status or language. Comparisons were made between patients with OSA, diagnosed in-laboratory polysomnography (PSG) or home sleep apnea testing (HSAT), and patients without OSA in relation to established markers of diastolic dysfunction. Results: Primary search identified 2512 studies. A total of 18 studies including 2509 participants were included. The two groups were free of conventional cardiovascular risk factors. Significant structural changes were observed between the two groups. Patients with OSA exhibited greater LAVI (3.94 CI [0.8, 7.07]; p=0.000) and left ventricular mass index (11.10 CI [2.56,19.65]; p=0.000) as compared to control group. The presence of OSA was also associated with more prolonged DT (10.44 ms CI [0.71,20.16]; p=0.04), IVRT (7.85 ms CI[4.48, 11.22]; p=0.000), and lower E/A ratio (-0.62 CI [-1,-0.24]; p=0.001) suggestive of early DD. The E/e’ ratio (0.94 CI[0.44, 1.45]; p=0.000) was increased. Conclusion: An association between OSA and echocardiographic parameters of DD was detected that was independent of conventional cardiovascular risk factors. OSA may be independently associated with DD perhaps due to higher LV mass. Investigating the role of CPAP therapy in reversing or ameliorating diastolic dysfunction is recommended.
01 Apr 2021Submitted to Echocardiography
01 Apr 2021Submission Checks Completed
01 Apr 2021Assigned to Editor
18 Apr 2021Reviewer(s) Assigned
24 May 2021Review(s) Completed, Editorial Evaluation Pending
31 May 2021Editorial Decision: Revise Major
02 Jun 20211st Revision Received
24 Aug 2021Submission Checks Completed
24 Aug 2021Assigned to Editor
25 Aug 2021Reviewer(s) Assigned
04 Sep 2021Review(s) Completed, Editorial Evaluation Pending
30 Aug 2022Published in Respiration on pages 1-18. 10.1159/000525782