The role of cardiac magnetic resonance imaging in obstructive sleep apnea: a systematic scoping review

Obstructive sleep apnea (OSA) is a prevalent condition associated with cardiovascular morbidity. Cardiac magnetic resonance imaging (CMR) provides a non-invasive modality for detecting subclinical cardiac changes in OSA, however its role in OSA diagnosis and management remains under-explored. We conducted a systematic scoping review to evaluate the utility of CMR in assessing cardiac remodelling and cardiovascular risk in OSA patients. Following the PRISMA guidelines, six databases (PubMed, Scopus, EMBASE, Google Scholar, Web of Science, and the Cochrane Library) were searched for studies on CMR use in OSA. A total of 21 studies met the inclusion criteria, providing data on left ventricular hypertrophy (LVH), myocardial fibrosis, right ventricular function, and pulmonary hypertension. The majority of studies indicated a significant correlation between OSA severity and adverse cardiac outcomes, including LVH, myocardial fibrosis, and right ventricular dysfunction. CMR demonstrated superior sensitivity in detecting these changes compared to other imaging modalities. Continuous positive airway pressure therapy was found to reduce left ventricular mass and improve right ventricular function in several studies, and showing the potential reversibility of OSA-related cardiac remodeling. CMR is a valuable tool in identifying early cardiovascular changes in OSA patients, with implications for earlier intervention and improved management of cardiovascular risk. Further research is warranted to standardise CMR protocols and explore long-term outcomes of CMR-guided interventions in OSA management.