ISSN : 2146-3123
E-ISSN : 2146-3131

Pericardial Effusion in Obstructive Sleep Apnea Without Pulmonary Arterial Hypertension and Daily Hypoxemia - is it Unusual?
Emil Ivanov Manov1, Ventsislava Pencheva1, Nikolay Margaritov Runev1, Stefan Naydenov1, Daniela Stoychkova Petrova1, Ognian Borisov Georgiev1
1Department of Internal Diseases “Prof. St. Kirkovich”, Medical University of Sofia, Sofia, Bulgaria
DOI : 10.4274/balkanmedj.2017.0580

Background: Pericardial effusion in chronic hypoxemic lung diseases such as obstructive sleep apnea syndrome usually occurs after the development of severe pulmonary arterial hypertension. However, data about the frequency of pericardial effusions in obstructive sleep apnea syndrome without pulmonary arterial hypertension and/or day-time hypoxemia are still scarce and their pathogenesis is unclear.

Aims: To assess the prevalence of pericardial effusions, their volume and location in patients with obesity and obstructive sleep apnea syndrome without pulmonary arterial hypertension and/or hypoxemia.

Study Design: Cross-sectional study.

Methods: We included 279 consecutive patients (162 males) with newly diagnosed obstructive sleep apnea syndrome, mean age 42.8±12.4 years, mean body mass index 37.3±7.8 kg/m2. Obstructive sleep apnea syndrome was confirmed by polysomnography. Main exclusion criteria were as follows: Concomitant inflammatory diseases, thyroid dysfunction, day-time hypoxemia, nephrotic syndrome, left ventricular systolic dysfunction and pulmonary arterial hypertension.

Results: Pericardial effusion was found in 102 (36.56%) - all of them with moderate to severe obstructive sleep apnea syndrome. The mean effusion volume was mild to moderate (up to 250 mL). In 36 patients (35.3%) the pleural effusion was diffuse, in 42 (41.2%) - located in front of the right atrium and the right ventricle and in 24 (23.5%) - in front of the right cardiac cavities and the left atrium. We found significant positive correlation between presence of pericardial effusion and: Apnea-hypopnea index (r=0.374, p<0.001), body mass index (r=0.473, p<0.001), desaturation time during sleep (r=0.289, p<0.001).

Conclusion: Pericardial effusion in patients with obesity and moderate to severe obstructive sleep apnea syndrome without daily hypoxemia and/or pulmonary hypertension is a relatively common finding. Occurrence of pericardial effusions is dependent mostly on the obstructive sleep apnea syndrome grade, the degree of obesity and the duration of sleep desaturation.

Keywords : Obstructive sleep apnea, pericardial effusion
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