Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 May 29;35(3):233-237.
doi: 10.4274/balkanmedj.2017.0580.

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

Emil Ivanov Manov  1 , Ventsislava Pencheva Pencheva  1 , Nikolay Margaritov Runev  1 , Stefan Naydenov Naydenov  1 , Daniela Stoychkova Petrova  1 , Ognian Borisov Georgiev  1
Affiliations

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

Emil Ivanov Manov et al. Balkan Med J. .

Abstract

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 daytime hypoxemia are still scarce, and their pathogenesis is unclear.

Aims: To assess the prevalence of pericardial effusions and 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 having a mean age of 42.8±12.4 years and a mean body mass index of 37.3±7.8 kg/m2. Obstructive Sleep Apnea syndrome was confirmed by polysomnography. Main exclusion criteria were concomitant inflammatory diseases, thyroid dysfunction, daytime 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 pericardial effusion was diffuse, in 42 (41.2%), the pericardial effusion was located in front of the right atrium and the right ventricle, and in 24 (23.5%) the pericardial effusion was situated in front of the right cardiac cavities and the left atrium. We found a significant positive correlation between the presence of pericardial effusion and apnea-hypopnea index (r=0.374, p<0.001), body mass index (r=0.473, p<0.001), and 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. The occurrence of pericardial effusions is dependent mostly on the grade of Obstructive Sleep Apnea syndrome, degree of obesity, and duration of sleep desaturation.

Keywords: Obesity; obstructive sleep apnea; pericardial effusion.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: No conflict of interest was declared by the authors.

Figures

Figure 1
Figure 1. Location of pericardial effusions in analyzed patients with obstructive sleep apnea syndrome without pulmonary arterial hypertension and/or daytime hypoxemia.
Figure 2
Figure 2. ROC-curve of apnea-hypopnea index for prediction of pericardial effusion.
Figure 3
Figure 3. ROC-curve of body mass index for prediction of pericardial effusion.
Figure 4
Figure 4. ROC-curve of desaturation time for prediction of pericardial effusion.
See this image and copyright information in PMC

References

    1. Guilleminault C, Tilkian A, Dement WC. The sleep apnea syndromes. Annu Rev Med. 1976;27:465–84. - PubMed
    1. Punjabi NM. The Epidemiology of Adult Obstructive Sleep Apnea. Proc Am Thorac Soc. 2008;5:136–43. - PMC - PubMed
    1. Marin JM, Carrizo SJ, Vicente E, Agusti AG. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet. 2005;365:1046–53. - PubMed
    1. Natanzon A, Kronzon I. Pericardial and pleural effusions in congestive heart failure - anatomical, pathophysiologic, and clinical considerations. Am J Med Sci. 2009;338:211–6. - PubMed
    1. Johnson JL. Pleural effusions in cardiovascular disease. Pearls for correlating the evidence with the cause. Postgrad Med. 2000;107:95–101. - PubMed