Danica Lisulov Popovic, Krotin Mirjana, Zdravkovic Marija, Soldatovic Ivan, Zdravkovic Darko, Brajkovic Milica, Gardijan Vera, Saric Jelena, Pokrajac Ruzica, Lovic Dragan, Stevanovic Predrag, Gajic Milina Tancic, Vukcevic Miodrag
University Clinical Hospital Center Bezanijska Kosa, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
Institute for Biomedical Statistics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
ScientificWorldJournal. 2014 Feb 27;2014:898746. doi: 10.1155/2014/898746. eCollection 2014.
The aim of the study was to evaluate whether obstructive sleep apnea (OSA) contributes directly to left ventricular (LV) diastolic and regional systolic dysfunction in newly diagnosed OSA with normal left ventricle ejection fraction.
125 consecutive patients were prospectively enrolled in the study. Control group consisted of 78 asymptomatic age-matched healthy subjects who did not have any cardiovascular and respiratory diseases. All patients had undergone overnight polysomnography and standard transthoracic and tissue Doppler imaging echocardiogram.
The E/A ratio and the peak E wave at mitral flow were significantly lower and the peak A wave at mitral flow was significantly higher in OSA patients compared with control subjects. Left ventricle isovolumetric relaxation time (IVRT) and mitral valve flow propagation (MVFP) were significantly longer in OSA patients than in controls. Tissue Doppler derived S' amplitude of lateral part at mitral valve (S'Lm) and E' wave amplitudes both at the lateral (E'Lm) and septal parts of the mitral valve (E'Sm) were significantly lower in OSA patients compared to controls.
Newly diagnosed OSA patients with normal global LV function have significantly impaired diastolic function and regional longitudinal systolic function. OSA is independently associated with these changes in LV function.
本研究的目的是评估在新诊断的左心室射血分数正常的阻塞性睡眠呼吸暂停(OSA)患者中,OSA是否直接导致左心室(LV)舒张功能和局部收缩功能障碍。
前瞻性纳入125例连续患者。对照组由78名年龄匹配的无症状健康受试者组成,他们没有任何心血管和呼吸系统疾病。所有患者均接受了夜间多导睡眠图检查以及标准经胸和组织多普勒成像超声心动图检查。
与对照组相比,OSA患者的E/A比值和二尖瓣血流E波峰值显著降低,二尖瓣血流A波峰值显著升高。OSA患者的左心室等容舒张时间(IVRT)和二尖瓣血流传播速度(MVFP)显著长于对照组。与对照组相比,OSA患者二尖瓣瓣环侧壁组织多普勒S'波幅度(S'Lm)以及二尖瓣侧壁(E'Lm)和间隔侧(E'Sm)的E'波幅度均显著降低。
新诊断的左心室整体功能正常的OSA患者存在明显的舒张功能障碍和局部纵向收缩功能障碍。OSA与左心室功能的这些变化独立相关。