Relationship Between Left Ventricular Diastolic Function And Geometric Patterns In Patients With Obstructive Sleep Apnea Syndrome By Echocardiography

Objective:To evaluate the correlation between left ventricular diastolic function and left ventricular geometry in patients of obstructive sleep apnea syndrome (OSAS), and discuss influencing factors by using echocardiographic technology.Methods:A study of181subjects with confirmed OSA, raging in ages from21to68years old, who had undergone their polysomnogram in our hospital because of snoring and the apnea hypopnea index(AHI)≥5. At the same time,we measure the OSAS patients’ fixed-point blood pressure.Allthe blood glucose,blood lipid and other biochemical examination,echocardiography of patients were collected in the next early morning. Patients,left ventricular configuration were divided into the normal geometry group (NG), concentric remodeling (CR) group, concentric hypertrophy group (EH) and concentric hypertrophy (CH) according to the relative wall thickness (RWT)≥0.42and left ventricular mass index (LVMI)≥46.7g/m2.7(female) or≥49.2g/m2.7(male). Left ventricular diastolic function indexes were measured by echocardiography. The correlation between left ventricular diastolic function and left ventricular configuration and its influencing factors were analysised by Pearson correlation analysis and multiple linear regression analysis.Results:①181cases of in patients with OSAS, NG71cases (39.2%), and CR40cases (22.1%), EH34cases (18.8%), CH36cases (19.9%), the difference of gender, age, heart rate, blood pressure, neck circumference, waist circumference, hip circumference, smoking history, TC, TG, HDL, LDL, fasting glucose, etc were not significant between the four groups (P>0.05).②Parameters of left ventricular diastolic function in patients with OSAS:The E peak was reduced obviously in EH, CH group, and there is a significant difference between the two groups; compared with NG group, E/A reduce gradually in CR, EH, CH group, the difference is significant, and the EH and CH groups have a significant difference, Em, Am and Em/Am reduce gradually in CR, EH, CH group, and the difference between groups is significant, E/Em increased gradually, the difference between EH, CH and NG, CR group is significant, and EH, CH group have significant difference;A, DT, IVRT, S, D, PVa and Vp did not differ between groups.③The parameters of Pearson correlation analysis of LVMI, RWT and left ventricular diastolic function parameter showed that the Em/Am with LVMI (r=-0.419) RWT(r=-0.289) were significantly negative correlation, E/Em with LVMI(r=0.638),RWT(r=0.328) were significantly positive correlation.④By the multivariate linear regression analysis of LVMI, RWT and left ventricular diastolic function parameters between Em/Am E/Em showed left ventricular diastolic function indexes Em/Am, E/Em were important factors that affect LVMI and RWT (R2=0.402,R2=0.107, P<0.001).Conclusions:①OSAS may result in left ventricular remodeling.②The left ventricular diastolic function of patients with left ventricular remodeling in OSAS is impaired, the left ventricular diastolic function is damaged heaviest in CH group.③Abnormal left ventricular diastolic dysfunction is associated with cardiac configuration change.