Assessment Of Right Ventricular Systolic And Diastolic Function In Patients With Obstructive Sleep Apean Syndrome By Echocardiography

Objective The study aimed to assess the changes of the right ventricular(RV)systolic and diastolic function in patients with obstructive sleep apnea syndrome(OSAS)using echocardiography,and to find the correlation between OSAS and the changes,and to investigate its clinical significance.Methods According to the apnea hypopnea index(AHI),30 moderate-to-severe OSAS patients were selected as study group,and 20 healthy volunteers were selected as control group.First,recorded the AHI,body mass index(BMI),systolic pressure and diastolic pressure of both the study group and the control group.Then,echocardiography was used to measure the right ventricular end-diastolic diameter(RVDD)and the right ventricular anterior wall(RVAW),the right atrium transverse diameter(RAT),the right atrial area(RAA)and the right atrial volume(RAV),the tricuspid inflow(early rapid filling wave,E;late filling wave,A),E deceleration time(EDT)and the right ventricular fraction of area change(FAC),tricuspid annular plane systolic excursion(TAPSE).The right atrial area and volume were corrected by body surface area(RAAI,RAVI).In apical four-chamber view tissue doppler mode(TDI)was performed to measure RV myocardial systolic velocity(Sa),early diastolic velocity(Ea),late diastolic velocity(Aa)and the time between the late diastolic A wave and the next E wave,the time of the whole S wave,the right ventricular isovolumic acceleration(IVA)and the right ventricular isovolumic relaxation time(IVRT).And then,RV myocardial performance index(MPI)was calculated.Results From the study between OSAS patients and the control group,we found that the RVDD and RVAW of the study group were increased,the FAC,TAPSE,Sa and IVA were reduced,MPI was increased(P<0.05).All of the changes showed that the systolic function of the right ventricular was attenuated.E,E/A,Ea were reduced(P<0.05),EDT,IVRT,E/Ea,RAT and RAVI were increased(P<0.05).That showed the diastolic function of RV was also attenuated.From the correlation analysis we found that the indices of the RV systolic function index(TAPSE,FAC,Sa,IVA,MPI),diastolic function index(EDT,E,E/A,Ea,E/Ea,IVRT)were associated with AHI.Multiple linear regression analysis showed that E/A,RVAW,IVRT,E/Ea were independent predictors of AHI.Conclusions OSAS is associated with the impaired RV systolic and diastolic function,and there has a direct relationship between the severity of OSAS and the level of RV dysfunction.E/A,RVAW,IVRT,E/Ea could be the predictors of the RV dysfunction in OSAS patients.We can evaluate the right ventricular function in patients with OSAS by echocardiography,and can provide favorable information for clinicians,and that has certain reference value for early diagnosis and treatment of patients with OSAS.