Estimate The Effects Of NCPAP Treatment To The Ventricular Systolic And Diastolic Function In Patients With Severe Obstructive Sleep Apnea-hypopnea Syndrome

Objective：To investigate the severe OSAHS in relation to left ventricular systolic anddiastolic function, and explore the effects of naSml continuous positive airway pressure on thesepatients. we comprehensively evaluated LV function using2dimensionalechocardiography(2DE),tissue Doppler imaging(TDI), and3dimensionalechocardiography(3DE) in subjects severe OSM, which were compared with patients withhypertension(no OSAHS) and healthy control subjects.Methods：We recruited severe OSAHS from July2012to February2013, and randomlyselected35as nCPAP therapy group(OSAHS group), which accepted mean12months nCPAPtherapy, and35patients with pure Hypertension(Hypertension group),35healthycohorts(Healthy group).All subjects underwent echocardiographic examination for theassessment of septal and posterior wall thickness, LV mass index, LV volumes and ejectionfraction, mitral valve inflow indices (E, A), mitral annular velocity (S, E’), and left atrial volumeindex (LAVI).Results：Posterior wall thickness and LV mass index were significantly higher in OSAHSand hypertensive groups compared with healthy(P＜0.05). Systolic S velocity was reduced inOSAHS and hypertensive compared with healthy control subjects (P＜0.05). Diastolic function(E/A, IVRT, and E/E’) was impaired in both OSAHS and hypertensive groups(P＜0.05).On2DE/3DE,mean LAVI was significantly greater in OSAHS and hypertensive compared withhealthy(P＜0.05).After mean12months clinical follow-up, according to nCPAP treatment guidelines,OSAHS group finalized29(83%) cases, after which the echocardiographic parameters werereassessed. In OSAHS patients, naSml continuous positive airway pressure therapy resulted inreduction of the posterior wall thickness (11±2VS.12±2,P=0.03) and improvement in LVejection fraction (P＜0.05), epworth score resulted in(5±4VS.13±5,P＜0.01) systolic S velocity (11±2VS.12±2，P=0.03), and diastolic LV impairment parameters, E/A(1.0±0.4VS.1.4±0.4,P＜0.01)，IVRT(0.09±0.02VS.0.07±0.02,P=0.02)，LAVI(P＜0.05)。Conclusion：Severe OSAHS causes structural and functional changes in LV function andare comparable to that seen in hypertension. These abnormalities significantly improve afterCPAP therapy. Indicates that patients with OSAHS by nCPAP therapy can reverse leftventricular structural changes to improve ventricular systolic and diastolic function, which canreduce cardiovascular complications and improve prognosis.