Endocrine Abstracts

Introduction: The interaction between diabetes and obstructive sleep apnea syndrome (OSAS) is little recognized. We hypothesized that diabetes and OSAS act synergistically to increase the risk of right ventricular systolic dysfunction and that treatment of OSAS would improve right ventricular (RV) systolic function in patients with diabetes plus OSAS.

Methods: Cross-sectional study including 100 patients with severe OSAS, 49 of whom have associated diabetes. Echocardiography was performed to study right systolic function and the effect of nocturnal continuous positive airway pressure(CPAP) ventilation in the diabetes and OSAS subgroup.

Results: We did not note any significant difference for the following ultrasound parameters: Tricuspid annular plane systolic excursion (TAPSE), Systolic Shortening Fraction, Global Longitudinal Strain of the RV. We noted a significant difference for the Systolic Wave Velocity at the lateral wall of the tricuspid annulus using Tissue Doppler Imaging (S’wave) parameter which was lower in the diabetes group (12.35 cm/s Vs 13.95 cm/s P=0.005). When OSAS is associated with diabetes, Systolic RV dysfunction was observed in 25% of the sample (64% in diabetics versus 36% in non-diabetics P=0.083). We found a marked improvement in the systolic function of the RV in patients with diabetes using CPAP (A systolic dysfunction rate of the RV at 12. 5% vs 87.5% in non-fitted P<0.001).

Conclusion: In patients with severe obstructive sleep apnea syndrome and diabetes, right ventricular dysfunction primarily involves the S’Wave parameter and CPAP improves right systolic function in diabetic patients with severe OSAS.