Clinical Study Of The Relationship Between Pulmonary Artery Stiffness And Left Ventricular Geometry In Patients With Obstructive Sleep Apnea Syndrome

Objective:Echocardiography was used to evaluate the structure and function of left ventricle and right ventricle and PAS in patients with obstructive sleep apnea syndrome（OSAS）with different left ventricular geometry,and the correlation between PAS and left ventricular geometry was analyzed.Methods:137 patients diagnosed with OSAS with apnea hypopnea index（AHI）≥5 times/h were monitored by polysomnography（PSG）.The general data of the patients were collected,including gender,age,body mass index,body surface area,heart rate,nocturnal blood pressure,blood glucose,blood lipid and echocardiography in the next morning.The collected cases were divided into 4 groups according to the left ventricle geometry tetralogy.Another 35 healthy volunteers served as the control group.The structural and functional parameters of the left and right ventricles and PAS were collected,and the differences between the five groups were compared.Pearson correlation analysis was performed on the structural and functional parameters of the PAS and the right ventricle.The risk factors related to left ventricular geometry were analyzed by disordered multi-classification Logistic regression.Results:（1）Comparison of general clinical data,PSG parameters and left ventricular parameters of each group:（1）Comparison of body mass index,body surface area,Nighttime systolic blood pressure,Nighttime diastolic blood pressure,cholesterol,triglyceride,AHI,Lowest Sa O₂and Mean Sa O₂among groups showed statistically significant differences（P<0.05）.（2）There were statistically obvious differences in LVDd,RWT,LVMI,E/A and left ventricular Tei index among all groups（P<0.05）.（2）Comparison of structural and functional parameters of right ventricle and pulmonary artery:（1）There were obvious significant differences in right ventricular diameter,Tei index,Et/At,SPAP,m PAP,RVEDV/BSA and RVESV/BSA among all groups（P<0.05）.There were no obvious differences in MPA,RVEF,TAPSE and RVSV/BSA among all groups（P>0.05）.（2）Compared with control group,PAS increased in each OSAS group（all P<0.05）.Compared with NG group,PAS increased in CR and EH group（P<0.05）.The PAS of CH group was significantly higher than that of the other 4 groups（P<0.05）.（3）Correlation analysis of PAS with 2D and 3D parameters of right ventricle and diameter of main pulmonary artery showed that:PAS was negatively correlated with Et/At,TAPSE,RVSV/BSA,RVEF（r=-0.372、-0.333、-0.217、-0.347,all P<0.05）,and positively correlated with right ventricular diameter,Tei index,RVEDV/BSA,RVESV/BSA,SPAP,and m PAP（r=0.376、0.366、0.421、0.354、0.469、0.639,all P<0.05）,there was no significant correlation with the MPA（r=0.032,P=0.673）.（4）Risk factors analysis of left ventricular geometry in patients with OSAS showed that AHI was correlated with CR（OR=1.155,P=0.018）,while systolic blood pressure and BMI were correlated with EH（OR=1.071,P=0.024;OR=1.149,P=0.044）,systolic blood pressure and PAS were correlated with CH（OR=1.092,P=0.007;OR=1.206,P=0.022）Conclusion:The structural and functional parameters of left ventricle and right ventricle and the changes of PAS were different in patients with OSAS with different left ventricular geometry.PAS is related to the occurrence of CH in the geometry of the left ventricle,suggesting that"right heart-pulmonary circulation-left heart"should be considered as a whole in clinical practice,so as to provide help for clinical decision-making.