Dursunoglu Nese, Dursunoglu Dursun, Ozkurt Sibel, Kuru Omür, Gür Sükrü, Kiter Göksel, Evyapan Fatma
Departments of Chest, Pamukkale University Medical Faculty, Kinikli, 20200 Denizli, Turkey.
Sleep Med. 2007 Jan;8(1):51-9. doi: 10.1016/j.sleep.2006.04.007. Epub 2006 Oct 4.
Obstructive sleep apnoea (OSA) has the potential to cause heart failure. We aimed to determine the effects of nasal continuous positive airway pressure (CPAP) therapy on left ventricular structure and myocardial performance index (MPI) in severe OSA patients.
Sixty-seven subjects without any cardiac or pulmonary disease had overnight polysomnography and echocardiography. In 33 males with severe OSA, thickness of interventricular septum (IVS) and posterior wall (LVPW) were measured by M-mode. Left ventricular MPI was calculated as (isovolumic contraction time+isovolumic relaxation time)/aortic ejection time by Doppler.
Eight males were non-compliant with CPAP. Mean age was 47.9+/-8.2 years, and 20 of 25 patients (80.0%) were hypertensive. Patients had high body mass index (BMI: 31.0+/-3.9 kg/m(2)), but there was no change in BMI from baseline after 6 months. Thickness of IVS (11.0+/-1.1mm) and LVPW (11.0+/-1.0mm) at baseline were significantly decreased after 6 months of CPAP therapy (10.5+/-0.9 mm, P<0.001 and 10.4+/-0.7 mm, P<0.0001, respectively). Left ventricular MPI (60.1+/-13.8%) significantly decreased (53.0+/-10.7%, P<0.0001) after CPAP usage.
In male patients with severe OSA, CPAP therapy significantly decreases left ventricular wall thickness and improves global function even with 6 months of usage.
阻塞性睡眠呼吸暂停（OSA）有可能导致心力衰竭。我们旨在确定鼻持续气道正压通气（CPAP）治疗对重度OSA患者左心室结构和心肌性能指数（MPI）的影响。
67名无任何心脏或肺部疾病的受试者进行了夜间多导睡眠图和超声心动图检查。在33名重度OSA男性患者中，采用M型测量室间隔（IVS）和后壁（LVPW）厚度。通过多普勒计算左心室MPI为（等容收缩时间+等容舒张时间）/主动脉射血时间。
8名男性不依从CPAP治疗。平均年龄为47.9±8.2岁，25名患者中有20名（80.0%）患有高血压。患者体重指数较高（BMI：31.0±3.9kg/m²），但6个月后BMI与基线相比无变化。CPAP治疗6个月后，基线时的IVS厚度（11.0±1.1mm）和LVPW厚度（11.0±1.0mm）显著降低（分别为10.5±0.9mm，P<0.001和10.4±0.7mm，P<0.0001）。使用CPAP后，左心室MPI（60.1±13.8%）显著降低（53.0±10.7%，P<0.0001）。
在重度OSA男性患者中，即使使用6个月，CPAP治疗也能显著降低左心室壁厚度并改善整体功能。
