ABC | Volume 113, Nº6, December 2019

Short Editorial Cunha Obstructive sleep apnea and LV diastolic function Arq Bras Cardiol. 2019; 113(6):1090-1091 1. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing amongmiddle-aged adults. NEngl J Med. 1993; 328(17):1230-5. 2. PeppardPE,YoungT,BarnetJH,PaltaM,HagenEW,HlaKM.Increasedprevalence ofsleep-disorderedbreathinginadults.AmJEpidemiol.2013;177(9):1006-14. 3. Friedman O, Logan AG. The price of obstructive sleep anea-hypopnea: hypertension and other ill effects. Am J Hypertens. 2009;22(5):479-83. 4. Bradley TD, Floras JS. Obstructive sleep apnoea and its cardiovascular consequences. Lancet. 2009;373(9657):83-9. 5. Myers KA, Mrkobrada M, Simel DL. Does this patient have obstructive sleep apnea? The Rational Clinical Examination systematic review. JAMA. 2013;310(7):731-41. 6. Leite AR, Martinez DM, Garcia-Rosa ML, Macedo EA, Lagoeiro AJ, Martins WA et al. Correlação entre Risco de Apneia Obstrutiva do Sono e Parâmetros do Ecocardiograma. Arq Bras Cardiol. 2019; 113(6):1084‑1089. 7. Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K et al . Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of SleepMedicine clinical practice guideline. J Clin Sleep Med. 2017;13(3):479-504. 8. CetinS,VuralM,AkdemirR,FiratH.Leftatrialremodellingmaypredictexercise capacity in obstructive sleep apnea patients. Acta Cardiol. 2018;73(5): 471-8. 9. Yu L, Li H, Liu X, Fan J, Zhu Q, Li J, et al . Left ventricular remodeling and dysfunction in obstructive sleep apnea: systematic reviewandmeta-analysis. Herz.2019. 2019 Sep 25 [Epub ahead of print]. 10. Sascau R, Zota IM, Statescu C, Boisteanu D, Roca M, Mastaleru A et al. Review of Echocardiographic Findings in Patients with Obstructive Sleep Apnea. Can Respir J. 2018 Nov 18; 1206217 References This is an open-access article distributed under the terms of the Creative Commons Attribution License A meta-analysis of 17 studies on LV remodeling and dysfunction in OSA, 9 concluded that this syndrome leads to left atrial dilation, and LV hypertrophy, dilation, increased mass and systolic function reduction. 9 The treatment of OSA may be beneficial in preserving LV structure and function. 9 An interesting review carried out in Romania by Sascau et al., 10 demonstrates that the moderate and severe forms of OSA are associated with increased atrial volumes, altered LV diastolic function and then LV systolic function. The assessment of right ventricular ejection fraction may also be compromised, being better evaluated by three‑dimensional echocardiography. Moreover, the contribution of two‑dimensional speckle‑tracking echocardiography has been very effective, differentiating between active and passive wall movements. Abnormal strain values, a subclinical marker of myocardial dysfunction, can be detected even in patients with normal ejection fraction and volumes. LV longitudinal strain is more affected by the presence of OSA. 10 In conclusion, the work by Leite et al. 6 highlights the contribution of echocardiography in OSA evaluation, a frequent disorder with different facets of pathophysiological interaction with cardiovascular diseases. The technological development of echocardiography, particularly with three‑dimensional and speckle tracking techniques, shows a continuing contribution to the study of OSA. 1091