Studty On The Right Cardiac Structure And Function In Patients With Obstructive Sleep Apnea Syndrome By Echocardiography

Objective: Obstructive sleep apnea syndrome refers patients with upper respiratory tract obstruction during sleep caused by repeated apnea and(or) lower ventilation.Resulting in intermittent hypoxia and hypercapnia,leading to a series of pathophysilogical changes,causeing the complications such as hypertension,coronary heart disease and cardiovascular disease. OSAS with potential danger,even can cause sudden death at night, which inciduce trends to a rise in recent years.It becomes more different to diagnsis and treatment OSAS, because of the complicated change of pathophysiology and the diversiform of clinical manifestations.Overseas and Domestic Research Status demonstrate that the right ventricular dysfunction is an strong independent predictor in early lesion of OSAS and its complications.Radionuclide examination, right ventricle angiography, magnetic resonance imaging, echocardiography are clinically common methods for right ventricular function examination. The echocardiography along with the advance of ultrasound machines, gradually become a common method to assess right ventricular function. Capacity measurement with Real-time three dimensional echocardiography(RT-3DE) is no longer dependent on the shape assumption. More convenient and repeatability in the measurement of irregular right ventricle has its unique advantage. Tei index is is a new technology developed for the evaluation of myocardial motion in recent years.Tei index reflecting the severity of OSAS and the relationship with right ventricular subclinical in OSAS, with high sensitivity.In this study, RT-3D and Tei index in patients with obstructive respiratory sleep suspended syndrome preliminary assessment of right ventricular function. This study investigated the differences between right ventricular structure and function in obstructive sleep apnea syndrome patients and healthy persons.The extent of right ventricular dysfunction lead to the realization of risk stratification,effcacy assessment and prognosis for patients.Methods: We chose 22 controls and 28 patients who were diagnosed OSAS in The First Hospital of Shijiazhuang City from 2014.1.1 to 2014.11.30, excluded patients with high blood pressure, coronary heart disease related to heart disease.We divided the patients with OSAS according to AHI into three groups: mild group(AHI for5~20), moderate group(AHI for21~40), the severe group(AHI>40).Control group and the proportion of patients with OSAS group of men and women, age composition and BMI are matching.Recorded control group and patients with OSAS group first general index: age, sex, body mass index(BMI).Height in meters(m) is a standard unit, the unit of weight in kilograms(Kg) as the standard.BMI=Kg/m2.Second OSAS group and the control group respectively make oxygen saturation(Sa O2), polysomnography detector and echocardiographic examination.Through polysomnography detector record its respiratory disturbance index(AHI) and the longest apnea time at night(Tmax) monitoring at the same time the research object of oxygen saturation,detection in the afternoon without a rest, smoking and alcohol, coffee and sedatives, record its average blood oxygen saturation(m Sa O2) and the lowest oxygen saturation at night(Sa O2min);By real-time three-dimensional echocardiography monitoring OSAS group and the control group of right ventricular function.Under the standard four cavity aspect nowadays start the 3 d model, take 4~5 a cardiac cycle, three-dimensional imaging, measure the right ventricular systolic volume(RVESV),right ventricular end-diastolic volume(RVEDV) by ultrasonic instrument with software to calculate right ventricular stroke volume(RVSV) and right ventricular ejection fraction(RVEF); By tissue doppler technology records in Tei index, application in cavity section 4 heart tissue doppler technique, the sampling volume in tricuspid ring with right ventricular free wall, such as on the spectrum measured ventricular volume contraction time(ICT), isovolumetric relaxation time(IRT), ejection time(ET).Right ventricular Tei index=(ICT+ IRT)/ET.The data were analyzed by SPSS 13.0 statistical software. The measurement data were expressed by mean±standard deviation( x ±SD).The measurement data satisfied normality and homogeneity of variance condition were analyzed by completely randomized design’s analysis of variance,the enumeration data were analyzed by Chi-square test. The analyze of the risk factor of right ventricular fuction was analyzed by Logistic regression.P<0.05 was considered as significance. The variables include age,BMI,nightly apnea time(Tmax),average blood oxygen saturation(m Sa O2) lowest blood oxygen saturation at night(Sa O2min).Result: Polysomnography test date analysis from normal control group and OSAS patients group in different cindition: PSG detection of each index(AHI, Tmax, m Sa O2, Sa O2min) had significant difference(P<0.05).The echocardiography index(Tei index, RVESV, RVEDV, RVSV and RVEF):In moderate and severe OSAS groups, there were significant differents in parameters of right ventricular function,compared with control group and mild OSAS groups.Integrated all the data from experiments OSAS patients,we found that right ventricular function in patients with OSAS is Tmax was positively related indicators.Tmax is one of important influencing factors which changes the right cardiac structure and function.Conclusion: OSAS can impair the right cardiacstructure and fuction have different degrees of demage. Right cardiac structure and function by RT-3DE and Tei index for OSAS provide effective clinical reference. Tmax is important influencing factor.