Evaluation Of Right Ventricular Structure And Function Of Different Left Ventricular Geometry In Patients With Obstructive Sleep Apnea Syndrome By Echocardiography

Objective:To evaluate the right ventricular structure and function of different left ventricular geometry in patients with obstructive sleep apnea syndrome(OSAS)by two-dimensional echocardiography combined withreal-time three-dimensional echocardiography(RT-3DE).Methods:201 patients with habitual snoring were diagnosed as OSAS by polysomnography with apnea hypopnea index(AHI)?5/h.General clinical characteristics and echocardiography were collected.On the basis of LV mass index(LVMI)? 99g/m2(female)or(male)108g/m2,relative wall thickness(RWT)?0.49(female)or 0.51(male),LV end-diastolic diameter?50mm(female)or 55mm(male),patients were divided into six groups: normal geometry(NG),concentric remodeling(CR),eccentric nondilated hypertrophy(ND-EH),concentric nondilated hypertrophy(ND-CH),eccentric dilated hypertrophy(D-EH)and concentric dilated hypertrophy(D-CH).Two-dimensional Echocardiography(2DE)and full volume images at apical four-chamber view were collected.Right ventricular volume curve,RVEDV,RVESV and RVEF were analyzed with QLAB workstation.Comparison of the differences of parameters among the six groups.Results:(1)There was no significant difference in general clinical parameters and PSG parameters among the six groups(P>0.05).(2)Left ventricular function parameters:(1)Compared with NG and CR groups,LVEF was significantly decreased in ND-CH and D-EH groups(P<0.05).(2)Compared with NG and CR groups,E/ A was significantly decreased in ND-EH,ND-CH,D-EH and D-CH groups(P <0.05);comparison with ND-CH group,E/e' was significantly increased in D-EH and D-CH groups(P <0.05).(3)2DE RV structural and function parameters :(1)compared with NG and CR groups,RVD was significantly increased in ND-EH and D-EH groups(P < 0.05);Compared with NG,CR and ND-EH groups,RVFW was significantly increased in ND-CH and D-CH groups(P < 0.05).(2)compared with NG and CR groups,E/A was significantly decreased in ND-CH,D-EH and D-CH groups(P<0.05);Compared with NG,CR,ND-E and ND-CH groups,E/e' was significantly increased in D-CH and D-EH groups(P < 0.05);Compared with NG,CR and ND-EH groups,Tei index was significantly increased in D-EH and D-CH groups(P < 0.05);Compared with NG,CR,ND-EH and ND-CH groups,TAPSE was significantly decreased in D-EH and D-CH groups(P<0.05);Compared with NG and CR groups,SPAP was significantly increased in ND-EH,ND-CH,D-CH groups(P<0.05).(4)RT-3DE RV structure and function parameters:(1)compared with NG and CR groups,RVEDV and RVESV were significantly increased in ND-EH,ND-CH,D-EH and D-CH groups(P<0.05);Compared with NG group,RVSV was significantly increased in ND-EH and D-EH groups(P < 0.05);(2)Compared with NG group,RVEF was significantly decreased in D-EH,D-CH and ND-EH and ND-CH groups(P<0.05).Conclusion:Different Left ventricular geometric patterns have different RV structure and function in OSAS,patients with ND-CH and D-CH and D-EH have worse structure and function of RV.It is suggested that the clinical need to pay attention to the right ventricular structure and function of OSAS patients with dilated LVH.