The Role of New Pulmonary Artery Wedge Pressure Formula to Predict Diastolic Dysfunction in Obstructive Sleep Apnea

Background: Heart failure (HF) is a common condition with high morbidity and mortality  in  Obstructive Sleep Apnea (OSA), especially in obese patient. The causes of HF are often abnormal conduction pathways, pump filling and/or heart valves. Right heart catheterization using Swan-Ganz catheter rema...

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Main Authors: Telly Kamelia, Lukman Hakim Makmun
Format: Article
Language:English
Published: Interna Publishing 2023-03-01
Series:Acta Medica Indonesiana
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Online Access:http://www.actamedindones.org/index.php/ijim/article/view/2212
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author Telly Kamelia
Lukman Hakim Makmun
author_facet Telly Kamelia
Lukman Hakim Makmun
author_sort Telly Kamelia
collection DOAJ
description Background: Heart failure (HF) is a common condition with high morbidity and mortality  in  Obstructive Sleep Apnea (OSA), especially in obese patient. The causes of HF are often abnormal conduction pathways, pump filling and/or heart valves. Right heart catheterization using Swan-Ganz catheter remains the gold standard to determine pulmonary hemodynamics, but it is costly and invasive. Herein, we propose a new formula for non-invasive Pulmonary artery wedge pressure (PAWP) measurement using tissue Doppler echocardiography. The purpose of this research is to explore the correlation between the new formula to calculate PAWP to predict diastolic dysfunction in OSA patients. Methods: A cross-sectional study was conducted in Jakarta, in March until October 2021. Eighty-two subjects were enrolled in the study, consist of 34 females and 48 males. All subjects underwent polysomnography and tissue Doppler echocardiography. Noninvasive measurement of PAWP were obtained from combined assessment of E/e’ and left atrial parameters. Results: Based on 82 subjects included, 66 subjects (80.5%) had obstructive sleep apnea, and 16 subjects (19.5%) did not have it. There was a significant difference in PAWP between patients with and without OSA (p value <0.01). Ten subjects OSA (12.1%) had diastolic dysfunction, while all non-OSA subjects had normal diastolic function, with no statistical significance between two groups (p value = 0.20). Diastolic dysfunction significantly associated with PAWP measured using proposed formula  (R = 0.240, p value = 0.030). Conclusion: The new formula could be used to indirectly calculate PAWP and predict diastolic dysfunction in OSA. Obstructive sleep apnea is associated with elevated PAWP. The increased risk of diastolic dysfunction in OSA, especially in obesity patient may indicate for the risk of cardiovascular morbidities.
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spelling doaj-art-c398b443a8cf4ff4983941cc5f885e1c2025-08-20T03:50:00ZengInterna PublishingActa Medica Indonesiana0125-93262338-27322023-03-01551The Role of New Pulmonary Artery Wedge Pressure Formula to Predict Diastolic Dysfunction in Obstructive Sleep ApneaTelly Kamelia0Lukman Hakim Makmun1Division of Respirology and Critical Care, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.Division of Cardiology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.Background: Heart failure (HF) is a common condition with high morbidity and mortality  in  Obstructive Sleep Apnea (OSA), especially in obese patient. The causes of HF are often abnormal conduction pathways, pump filling and/or heart valves. Right heart catheterization using Swan-Ganz catheter remains the gold standard to determine pulmonary hemodynamics, but it is costly and invasive. Herein, we propose a new formula for non-invasive Pulmonary artery wedge pressure (PAWP) measurement using tissue Doppler echocardiography. The purpose of this research is to explore the correlation between the new formula to calculate PAWP to predict diastolic dysfunction in OSA patients. Methods: A cross-sectional study was conducted in Jakarta, in March until October 2021. Eighty-two subjects were enrolled in the study, consist of 34 females and 48 males. All subjects underwent polysomnography and tissue Doppler echocardiography. Noninvasive measurement of PAWP were obtained from combined assessment of E/e’ and left atrial parameters. Results: Based on 82 subjects included, 66 subjects (80.5%) had obstructive sleep apnea, and 16 subjects (19.5%) did not have it. There was a significant difference in PAWP between patients with and without OSA (p value <0.01). Ten subjects OSA (12.1%) had diastolic dysfunction, while all non-OSA subjects had normal diastolic function, with no statistical significance between two groups (p value = 0.20). Diastolic dysfunction significantly associated with PAWP measured using proposed formula  (R = 0.240, p value = 0.030). Conclusion: The new formula could be used to indirectly calculate PAWP and predict diastolic dysfunction in OSA. Obstructive sleep apnea is associated with elevated PAWP. The increased risk of diastolic dysfunction in OSA, especially in obesity patient may indicate for the risk of cardiovascular morbidities.http://www.actamedindones.org/index.php/ijim/article/view/2212pulmonary artery wedge pressureobstructive sleep apneadiastolic dysfunction
spellingShingle Telly Kamelia
Lukman Hakim Makmun
The Role of New Pulmonary Artery Wedge Pressure Formula to Predict Diastolic Dysfunction in Obstructive Sleep Apnea
Acta Medica Indonesiana
pulmonary artery wedge pressure
obstructive sleep apnea
diastolic dysfunction
title The Role of New Pulmonary Artery Wedge Pressure Formula to Predict Diastolic Dysfunction in Obstructive Sleep Apnea
title_full The Role of New Pulmonary Artery Wedge Pressure Formula to Predict Diastolic Dysfunction in Obstructive Sleep Apnea
title_fullStr The Role of New Pulmonary Artery Wedge Pressure Formula to Predict Diastolic Dysfunction in Obstructive Sleep Apnea
title_full_unstemmed The Role of New Pulmonary Artery Wedge Pressure Formula to Predict Diastolic Dysfunction in Obstructive Sleep Apnea
title_short The Role of New Pulmonary Artery Wedge Pressure Formula to Predict Diastolic Dysfunction in Obstructive Sleep Apnea
title_sort role of new pulmonary artery wedge pressure formula to predict diastolic dysfunction in obstructive sleep apnea
topic pulmonary artery wedge pressure
obstructive sleep apnea
diastolic dysfunction
url http://www.actamedindones.org/index.php/ijim/article/view/2212
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