Correlation Between Pulmonary Artery Stiffness And Right Ventricular Function In Patients With OSAHS

Objective To investigate the relationship between pulmonary artery stiffness(PAS)and right ventricular diastolic and systolic function in patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods Sixty OSAHS patients from December 2017 to December 2018 in the General Hospital of Ningxia Medical University were collected as the OSAHS group,according to the patient's apnea hypopnea index(AHI)divided OSAHS group into three part:mild,moderate and severe.The mild group(15>AHI?5 times/h),the moderate group(30>AHI?15 times/h)and severe group(AHI ? 30 times / h).In the same time selected 31 health subjects as the control group,collected all subjects clinical and general data.Compare the general data of the experimental and the control group,including AHI,snoring index,minimum oxygen saturation,heart rate,LVEF,RVAW-t,PA,PV0,MFS,PAcT,PAS,mPAP,sPAP,RVEDV,RVESV,RVSV,RVEF,TAPSE,tE,tA,tSa,tE',tA'.Pearson's correlation was used to analyze the correlation between PAS and AHI,right ventricular diastolic and systolic function.Receiver operating characteristic curve(ROC)is plotted to determine the critical value of the PAS.Results 1.There were no significant differences in age,gender,heart rate,BMI and blood pressure between the OSAHS group and the control group(P>0.05).The AHI,snoring index and minimum oxygen saturation of the OSAHS group were higher than those of the control group(P<0.05).2.There were no significant difference between the OSAHS group and the control group in LVEF,MPA and PEcT(P>0.05).The RVAW-t,Pv0,MFS and PAS ofthe OSAHS group were significantly higher than the control group(P<0.05),and the PAcT was significantly lower than the control group(P<0.05).3.LVEF was no differences among three groups(P>0.05).Compared with the mild group,the PAcT was significantly decreased in the moderate group,and the RVAW-t,Pv0,MFS,and PAS were significantly increased(all P<0.05).Compared with the mild group,the MPA and PAcT in the severe group were significantly decreased,and the RVAW-t,Pv0,MFS,and PAS were significantly increased(all P<0.05).Compared with the moderate group,the PAcT was significantly decreased in the severe group,and the RVAW-t and PAS were significantly increased(both P<0.05).4.The parameters of right ventricular diastolic function evaluation in the OSAHS group and the control group were compared.The results showed that the tE,tE/tA,tE',tA',tE'/tA' of the OSAHS group were significantly lower than the control group(P<0.05).tA,tE/tE' was significantly higher than the control group(P<0.05);5.Mild,moderate and severe tE'/tA'were not statistically significant(P>0.05).Compared with the mild group,the moderate group tE,tE/tA,tE/tE' was significantly reduced,and tA was significantly increased(both P<0.05).Compared with the mild group,the severe groups tE,tE/tA,tE',tE/tE' were significantly reduced,and tA and tA' were significantly increased(both P < 0.05).Compared with the moderate group,the severe groups tA,tE/tA,tE' were significantly reduced,and tA' was significantly increased(both P<0.05);6.Comparing the parameters of right ventricular systolic function in the OSAHS group and the control group,the RVSV of the OSAHS group was not significantly difference whith the control group.The RVEF and tSa of the OSAHS group were significantly lower than the control group(P<0.05),RVEDV,SPAP,mPAP was significantly higher than the control group(P<0.05).7.Mild,moderate and severe were RVSV was not statistically significant(P>0.05).Compared with the mild group,RVEF and TAPSE were significantly decreased in the moderate group,and RVEDV,RVESV,SPAP,and mPAP were significantly increased(all P<0.05).Compared with the mild group,RVEF,TAPSE,and tSa were significantly decreased in the severe group,and RVEDV,RVESV,SPAP,and mPAP were significantly increased(all P<0.05).Compared with the moderate group,the RVEF and tSa were significantly decreased in the severe group,and the SPAP and mPAP were significantly increased(P<0.05).8.The study found a significant positive correlation between the polysomnographic monitoring variable AHI and PAS in the OSAHS group(r = 0.722,P=0.000);9.Correlation analysis between PAS and right ventricular diastolic function evaluation parameters showed no significant correlation between PAS and tE'/tA',tE/tE',and tE,tE/tA,tE There was a significant negative correlation between ',tA' and a significant positive correlation with tA;10.Correlation between PAS and experimental group right ventricular systolic function evaluation parameters,PAS and RVSV,RVEF,TAPSE,tSa were observed.There was a significant negative correlation between the two groups,and there was a significant positive correlation with RVEDV,RVESV,SPAP,and mPAP.The area under the ROC curve for 11 PAS to determine the impairment of right ventricular function was 0.891[95% confidence interval(95% CI)=0.822-0.959).].The critical value of PAS is 17.775kHz/sec.Conclusion OSAHS patient the systolic and diastolic function of the right ventricle that decreases with the severity of the disease.As a new Doppler index,PAS gradually increased with the severity of OSAHS disease,and it has a higher correlation with the right ventricular systolic and diastolic function in OSAHS patients.The statistical value is used to calculate the critical value of PAS 17.775kHz/sec.