Evaluation Of Early Left Ventricular Diastolic And Systolic Dysfunction In Patients With Obstructive Sleep Apnea With Normal Left Ventricular Ejection Fraction By Two-dimensional Speckle Tracking Technique

Objective:To evaluate left ventricular systolic and diastolic function in patients with obstructive sleep apnea syndrome?OSAHS?with normal left ventricular ejection fraction by two-dimensional speckle tracking technique.Methods:?1?OSAHS patients in our hospital were included.AHI was used to determine the severity of the disease,and the patients who had no related diseases at the same time were used as control.The general information of patients with blood lipids,blood glucose and other biochemical indexes were recorded to determine the distribution of obesity,hypertension,dyslipidemia and diabetes.?2?Theindexes ofleftventricleweremeasuredby conventional echocardiography.?3?Left ventricular peak systolic longitudinal strain?LS?,peak systolic radial strain?RS?,peak systolic circumferential strain?CS?and longitudinal peak early diastolic strain rate?Sr Le?,circumferential peak early diastolic strain rate?SrCe?,radial peak early diastolic strain rate?Sr Re?were evaluate using two-dimensional speckle tracking.?4?Using the Pearson correlation to analysis correlation between conventional echocardiography or speckle tracking indexes and AHI.?5?The independent variables of P<0.1 were included in the correlation analysis,and the multivariate linear regression analysis was carried out with AHI as the dependent variable.Results:?1?A total of 142 OSAHS patients were collected,including 87 cases of mild group?61.26%?,42 cases of moderate group?29.58%?and 8 cases of severe group?5.63%?.78 cases were selected as the control group.OSAHS group had higher smoking rate and drinking rate,and higher incidence of obesity,hypertension,dyslipidemia,diabetesand other diseases.?2?As the severity of the disease increased,both AHI and SDU showed an upward trend.MSa O₂ and SDU showed a downward trend.?3?the IVST of group OSAHS was 11.13±1.64mm and LVPWT was 10.63±1.72mm,which was significantly higher than that of the control group?P<0.05?.?4?the LVEDD of OSAHS group was 51.39±4.31mm and LVESV was 33.63±9.51ml,which was significantly higher than that of the control group?P<0.05?.The LS in the middle part of group OSAHS is-18.82±5.87%,the apical segment LS is-16.76±5.36%,RS is 34.68±7.96%,CS is-18.75±7.97%,the left ventricular LS is-19.41±3.62%,RS is 33.32±7.83%,and the CS is-17.27±6.15%,the absolute value is lower than that of the control group.?5?There were no significant differences between the two groups of E,A,E/A,IVRT?P>0.05?.?6?The OSAHS group of apical long axis SrLe was 1.62±0.29s^-1,apical two chamber SrLe was 1.85±0.34s^-1,apical four chamber SrLe was 1.79±0.38s^-1,left ventricular Sr Le was 1.72±0.29s^-1,apex level of Sr Ce was 1.86±0.31s^-1,left ventricular SrCe was 1.95±0.30s^-1;level of OSAHS group of papillary muscle Sr Re-2.13±0.55s^-1,level of OSAHS group of apex level Sr Re was-2.39±0.45s^-1,Sr Re for left ventricular was-2.17±0.48s^-1,the absolute values were lower than the control group;?8?AHI corralate with LVPWDT?r=0.174?,LVEDD?r=0.761?,LS?r=-0.827?,apical segment of left ventricular LS?r=-0.810?,left ventricular?RS r=-0.848?,apical CS?r=-0.828?,left ventricular CS?r=--0.775?,left ventricular SrLe?r=-0.699?,left ventricular Sr Ce?r=-0.698??P<0.05?;?9?Multiple linear regression analysis showed LVEDD partial regression coefficient is 0.252,apical LS partial regression coefficient was-0.774,left ventricular LS partial regression coefficient was-0.719,left ventricular RS partial regression coefficient was-0.694,apical CS partial regression coefficient was-0.691,left ventricular SrLe partial regression coefficient was-0.549,apical level SrCe partial regression coefficient of-0.647?P<0.05?.Conclusion:Left ventricular systolic function and left ventricular diastolic function in OSAHS patients with normal LVEF was abnormal;Snice the high sensitivity of speckle tracking,it is suitable for evaluation of cardiac function in patients with early OSAHS patients;the damage of systolic and diastolic function in OSAHS patients with were mainly concentrated in the long axis,starting from the apical segment,which has the order and direction is obvious;the decline of heart function in patients with OSAHS may be the interaction between OSAHS and the severity of the disease.