Identifying early left atrial dysfunction in individuals with obstructive sleep apnea: The role of the morphology-voltage-P wave duration electrocardiography score

Background: Obstructive sleep apnea (OSA) can lead to left atrial (LA) dysfunction, which increases the risk of severe heart problems such as atrial fibrillation and heart failure. Early detection of LA dysfunction is essential to prevent these complications. We investigated whether the new morphology-voltage-P wave duration electrocardiography (MVP ECG) level could effectively identify early-stage LA functional abnormality in OSA individuals, as current diagnostic techniques have limitations. Methods: We studied a sample of 120 OSA patients using speckle-tracking echocardiography to assess LA function. After the echocardiography exam, we divided these individuals into two groups: those with regular LA and those with impaired LA functions. Our main measure of LA function was peak atrial longitudinal strain (PALS). Results: We found significant differences in PALS values between groups (p <0.001) despite having an equivalent LA size, suggesting occult LA dysfunction in OSA patients. The MVP ECG score proved effective in identifying LA dysfunction caused by changes in atrial structure (sensitivity: 89 %, specificity: 63 %, AUC: 0.862). Conclusions: The MVP ECG score is a promising non-invasive method to detect early atrial changes in OSA patients. Using this score in regular medical care could help physicians intervene earlier, potentially reducing the risk of heart problems in these high-risk individuals.