Pericardial Effusion in Obstructive Sleep Apnea without Pulmonary Arterial Hypertension and Daily Hypoxemia - is it Unusual?

Abstract

Background: Pericardial effusion in chronic hypoxemic lung diseases,such as Obstructive Sleep Apnea syndrome, usually occurs after thedevelopment of severe pulmonary arterial hypertension. However,data about the frequency of pericardial effusions in Obstructive SleepApnea syndrome without pulmonary arterial hypertension and/ordaytime hypoxemia are still scarce, and their pathogenesis is unclear.Aims: To assess the prevalence of pericardial effusions and their volumeand location in patients with obesity and Obstructive Sleep Apneasyndrome 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 havinga mean age of 42.8±12.4 years and a mean body mass index of37.3±7.8 kg/m2. Obstructive Sleep Apnea syndrome was confirmedby polysomnography. Main exclusion criteria were concomitantinflammatory diseases, thyroid dysfunction, daytime hypoxemia,nephrotic syndrome, left ventricular systolic dysfunction andpulmonary arterial hypertension.Results: Pericardial effusion was found in 102 (36.56%) -all of themwith moderate to severe obstructive Sleep Apnea syndrome. Themean effusion volume was mild to moderate (up to 250 mL). In 36patients (35.3%) the pericardial effusion was diffuse, in 42 (41.2%),the pericardial effusion was located in front of the right atrium andthe right ventricle, and in 24 (23.5%) the pericardial effusion wassituated in front of the right cardiac cavities and the left atrium.We found a significant positive correlation between the presence ofpericardial effusion and apnea-hypopnea index (r=0.374, p