Moro José A, Almenar Luis, Fernández-Fabrellas Estrella, Ponce Silvia, Blanquer Rafael, Salvador Antonio
Fundación para la Investigación, Hospital Universitario La Fe, Valencia, España.
Arch Bronconeumol. 2008 Aug;44(8):418-23.
Sleep apnea-hypopnea syndrome (SAHS) is an emerging disease with considerable cardiovascular impact. The myocardial performance index (MPI) is an echocardiographic parameter that is useful in the assessment of global myocardial function. The purpose of this study was to identify any differences in the MPI between patients with and without SAHS.
We studied 120 consecutive patients referred to our department for suspected SAHS. Following the overnight sleep study and after excluding all patients with hypertension, heart disease, or invalid recordings, 54 patients with SAHS and 13 patients without the disease matched for age and body mass were analyzed. A blinded cardiologist performed Doppler echocardiography, measuring parameters related to ventricular hypertrophy, systolic function, diastolic function, and the MPI. The data were compared by chi(2) and analysis of variance.
Mean (SD) ventricular mass was greater in patients with SAHS (183.17 [40.5] g) than in those without that diagnosis (149 [26] g) (P=.005). No differences were observed in systolic function (78.5% [8.95%] vs 81.6% [7%]) (P=.2), although a higher percentage of patients with SAHS had abnormal diastolic function (71.2% vs 38.5%) (P=.049). The MPI was significantly higher in SAHS patients (0.54 [0.12] vs 0.46 [0.07]) (P=.028).
On its own, SAHS leads to left ventricular hypertrophy. Diastolic involvement is common in these patients, although a large number of healthy individuals who are obese also present it. The MPI is higher in SAHS and could be a useful parameter to identify patients with silent heart disease before it progresses.
睡眠呼吸暂停低通气综合征（SAHS）是一种对心血管系统有重大影响的新兴疾病。心肌性能指数（MPI）是一种超声心动图参数，有助于评估整体心肌功能。本研究的目的是确定SAHS患者与非SAHS患者之间MPI的差异。
我们研究了120例因疑似SAHS转诊至我科的连续患者。经过整夜睡眠研究，并排除所有患有高血压、心脏病或记录无效的患者后，分析了54例SAHS患者和13例年龄和体重匹配的非SAHS患者。一位不知情的心脏病专家进行了多普勒超声心动图检查，测量与心室肥厚、收缩功能、舒张功能和MPI相关的参数。数据通过卡方检验和方差分析进行比较。
SAHS患者的平均（标准差）心室质量（183.17 [40.5] g）高于未诊断出该病的患者（149 [26] g）（P = 0.005）。收缩功能方面未观察到差异（78.5% [8.95%] 对81.6% [7%]）（P = 0.2），尽管SAHS患者舒张功能异常的比例更高（71.2% 对38.5%）（P = 0.049）。SAHS患者的MPI显著更高（0.54 [0.12] 对0.46 [0.07]）（P = 0.028）。
SAHS本身会导致左心室肥厚。舒张功能受累在这些患者中很常见，尽管大量肥胖的健康个体也存在这种情况。SAHS患者的MPI更高，可能是在无症状心脏病进展之前识别患者的有用参数。
