Effects of obstructive sleep apnea treatment on left atrial volume and left atrial volume index

Obstructive sleep apnea (OSA) and increased left atrial volume (LAV) both independently increase cardiovascular mortality. We hypothesized that treatment of OSA with continuous positive airway pressure (CPAP) may decrease LAV. We retrospectively identified 47 OSA patients receiving CPAP who had echocardiograms done before and after polysomnography. Compliance was defined as CPAP use at-least five nights weekly and 5 h per night. The compliant group (n=23) had a significant decrease in diastolic blood pressure (DBP; 4.4±8.9 mmHg, p<0.05) and mean arterial pressure (MAP; 4.7±10.3 mmHg, p<0.05), while no significant changes were observed in the noncompliant group (n = 24). LAV data were available in 13 compliant and 20 noncompliant patients. LAV decreased nonsignificantly (3.54±6.6 mL, n = 3, p = 0.65) in CPAP-compliant patients, while it increased (15.47±22.3 mL, n=20, p<0.006) in noncompliant patients. Similar changes were seen in the LAV index. Untreated OSA was associated with an increase in LAV and LAV index without significant changes in blood pressure. Treatment of OSA was associated with a decrease in DBP and MAP with a nonsignificant decrease in LAV. Treatment of OSA may prevent adverse left atrial remodeling.