Department of Cardiology, Kartal Kosuyolu Yuksek Ihtisas Heart Education and Research Hospital, Istanbul, Turkey.
Sleep Breath. 2013 Sep;17(3):975-83. doi: 10.1007/s11325-012-0786-z. Epub 2012 Nov 16.
Sleep deprivation (SD) is known to be associated with adverse cardiovascular events. Strain and strain rate measure the local deformation of the myocardium and have been used to evaluate atrial phasic function in various disease states. The aim of the study was to investigate whether strain rate imaging enables the identification of left atrial dysfunction in otherwise healthy young adults with acute SD which has not been studied previously.
Adequate echocardiographic images of 27 healthy volunteers were obtained both after a night with regular sleep and after a night with SD. Tissue Doppler-derived strain and strain rate were measured from the apical four- and two-chamber views of the left atrium, and global values were calculated as the mean of all segments. Measurements included peak systolic strain, systolic strain rate (S-Sr), early diastolic (E-Sr) and late diastolic (A-Sr) strain rate. Phasic left atrial (LA) volumes and fractions were also calculated.
There was no significant difference in the traditional parameters of atrial function and LA volumes. Subjects had similar S-Sr, A-Sr and global atrial strain values after the night of sleep debt when compared after regular sleep, whereas they had significantly reduced E-Sr values (mean (SD) 3.2 (0.7) s(-1) vs 3.7 (0.6) s(-1), p < 0.001). Moreover, global E-Sr showed a significant correlation with sleep time (r = 0.554, p < 0.001).
Acute SD in healthy adults is associated with a reduction in LA early diastolic strain rate in the absence of geometric alterations or functional impairment of the left atrium, raising the possibility that chronic SD may more profoundly affect LA function and thereby promote the occurrence of atrial fibrillation.
众所周知,睡眠剥夺(SD)与不良心血管事件有关。应变率和应变率测量心肌的局部变形,并已被用于评估各种疾病状态下的心房相功能。本研究旨在探讨应变率成像是否能够在以前未研究过的情况下,识别出睡眠剥夺的健康年轻成年人的左心房功能障碍。
在一夜正常睡眠和一夜睡眠剥夺后,对 27 名健康志愿者进行了充分的超声心动图检查。从左心房的顶部四腔和两腔视图中获取组织多普勒衍生的应变率和应变率,并将所有节段的平均值作为整体值进行计算。测量包括收缩期峰值应变、收缩期应变率(S-Sr)、早期舒张期(E-Sr)和晚期舒张期(A-Sr)应变率。还计算了左心房(LA)的相容积和分数。
在传统的心房功能参数和 LA 容积方面,两组间无显著差异。与正常睡眠相比,在睡眠债务之夜后,受试者的 S-Sr、A-Sr 和整体心房应变值相似,而 E-Sr 值显著降低(平均值(标准差)为 3.2(0.7)s(-1) 比 3.7(0.6)s(-1),p<0.001)。此外,整体 E-Sr 与睡眠时间呈显著相关性(r=0.554,p<0.001)。
在健康成年人中,急性 SD 与左心房早期舒张期应变率降低有关,而左心房的几何改变或功能障碍不存在,这提示慢性 SD 可能更严重地影响左心房功能,并因此促进心房颤动的发生。