Evaluation Of Left Ventricular Global Systolic Function In Patients With Obstructive Sleep Apnea Hypopnea Syndrome And Hypetrension By Three-dimensional Speckle Tracking Imaging

ObjectiveTo evaluate the left ventricular global systolic function withthree-dimensional speckle tracking imaging (3D-STI) in obstructive sleep apneahypopnea syndrome (OSAHS) patients with hypertension (HT).MethodsTotally62patients with OSAHS were divided into OSAHS group （n=31）and OSAHS with HT group (n=31). In addition,31healthy people were set asthe control group.All subjects were examined by GE Vivid E9color dopplerultrasonic diagnosis apparatus.Conventional ultrasound access to get followingparameters:left ventricular internal diastolic dimension(LVIDd), diastolicthickness of left interventricular septum(IVsd),diastolic ventricular posterior wallthickness(LVPWD),peak velocity of the early diastolic (E),peak velocity of thelate diastolic (A),and calculate the E/A values.Using apical biplane Simpson’smethod to measure left ventricular ejection fraction (LVEF).Acquired leftventricular apical four chamber view of three-dimensional volume.3D-STIsoftware were applied to acquire the LV global longitudinal peak systolic strain(GLS),global radial peak systolic strain (GRS),global circumferential peaksystolic strain (GCS) and global area peak systolic strain (GAS).Compare thedifferences among the parameters of three groups,calculate the correlationbetween GAS and GLS, GRS, GCS and above3D-STI parameters with LVEF. Results1、Comparison of general parametersThree groups in age, heart rate showed no significant difference (P＞0.05).Compared with normal control group,AHI was significantly higher (P＜0.05),LSaO2and MSaO2were significantly lower (P＜0.05) in OSAHSgroup.BMI,Systolic blood pressure,diastolic blood pressure,AHI weresignificantly higher in OSAHS+HT group (P＜0.05), while LSaO2, MSaO2weresignificantly lower (P＜0.05).BMI,Systolic blood pressure,diastolic bloodpressure,AHI was significantly higher,LSaO2significantly lower (P＜0.05) inOSAHS+HT group than in the OSAHS group (P＜0.05).2、Comparison of parameters from two-dimensionalechocardiographyCompared with the normal control group,IVsd,LVPWD were higher inOSAHS group(P＜0.05),while mitral E wave peak and E/A were reduced (P＜0.05).Compared with normal control group,LVIDd,IVsd,LVPWD,LVMI wereincreased in OSAHS+HT group(P＜0.05), while mitral E wave peak and E/Awere reduced (P＜0.05).IVsd,LVPWD,LVMI group were increased inOSAHS+HT group compared with OSAHS,while E/A was reduced (P＜0.05).Three groups EF and mitral A wave peak was no significant difference(P＞0.05)3、Comparison of three-speckle tracking imagingCompared with the control group,LV GLS,GRS,GAS were reduced inOSAHS group (P＜0.05).LV GLS,GRS,GCS,GAS were also reduced in OSAHSwith HT (P＜0.05).Compared with those in OSAHS group,GLS,GCS,GAS werelower in OSAHS with HT (P＜0.05).4、Correlation analysis Control group LVGLS, LVGRS, LVGCS and LVGAS associated with LVEF(r1=-0.86, Pl＜0.01; r2=0.68, P2＜0.01; r3=-0.66, P3＜0.01; r4=-0.78, P4＜0.01); OSAHS group LVGLS, LVGRS, LVGCS and LVGAS associated withLVEF (r1=-0.80, P1＜0.01; r2=0.57, P2＜0.01; r3=-0.68, P3＜0.01; r4=-0.71,P4＜0.01). OSAHS+HT group LVGLS, LVGRS, LVGCS and LVGAS associatedwith LVEF (r1=-0.83, P1＜0.01; r2=0.66, P2＜0.01; r3=-0.71, P3＜0.01; r4=-0.75, P4＜0.01). LVGLS, LVGCS,LVGRS, associated with LVGAS (r1=0.76,P1＜0.01; r2=0.74, P2＜0.01; r3=-0.66, P3＜0.01).Conclusions1、Global systolic function and myocardial strain decreased in OSAHSpatients and OSAHS patients with HT.2、 OSAHS patients changes in cardiac structure and function isindependent of the presence of HT alone, HT aggravates the structure andfunction of LV in patients with OSAHS.3、3D-STI identifies early left ventricular global functional changes inOSAHS patients with HT,and provide a new sensitive indicator for the clinicalassessment.