阻塞性睡眠呼吸暂停与超声心动图参数的风险。
Risk of Obstructive Sleep Apnea and Echocardiographic Parameters.
机构信息
Universidade Federal Fluminense - Medicina Clinica, Niterói, RJ - Brazil.
出版信息
Arq Bras Cardiol. 2019 Dec;113(6):1084-1089. doi: 10.5935/abc.20190181.
BACKGROUND
Obstructive sleep apnea (OSA) is a chronic progressive disorder with high mortality and morbidity rate, associated with cardiovascular diseases (CVD), especially heart failure (HF). The pathophysiological changes related to OSA can directly affect the diastolic function of the left ventricle.
OBJECTIVES
To assess the association of the risk of OSA, evaluated by the Berlin Questionnaire (BQ), and echocardiographic (ECHO) parameters related to diastolic dysfunction in individuals without HF assisted in primary care.
METHODS
A cross-sectional study that included 354 individuals (51% women) aged 45 years or older. All individuals selected were submitted to an evaluation that included the following procedures: consultation, filling out the BQ, clinical examination, laboratory examination and transthoracic Doppler echocardiography (TDE). Continuous data are presented as medians and interquartile intervals, and categoric variables in absolute and relative frequencies. The variables associated with risk of OSA and at the 0.05 level integrated the gamma regression models with a log link function. A value of p < 0.05 was considered an indicator of statistical significance. Exclusion criteria were presence of HF, to fill out the BQ and patients with hypertension and obesity not classified as high risk for OSA by other criteria. All individuals were evaluated on a single day with the following procedures: medical appointment, BQ, laboratory tests and ECHO.
RESULTS
Of the 354 individuals assessed, 63% were classified as having high risk for OSA. The patients with high risk for OSA present significantly abnormal diastolic function parameters. High risk for OSA confirmed positive and statistically significant association, after adjustments, with indicators of diastolic function, such as indexed left atrium volume LAV-i (p = 0.02); E'/A' (p < 0.01), A (p = 0.02), E/A (p < 0.01).
CONCLUSION
Our data show that patients at high risk for OSA present worsened diastolic function parameters measured by TDE.
背景
阻塞性睡眠呼吸暂停（OSA）是一种具有高死亡率和发病率的慢性进行性疾病，与心血管疾病（CVD）相关，特别是心力衰竭（HF）。与 OSA 相关的病理生理变化可直接影响左心室的舒张功能。
目的
评估柏林问卷（BQ）评估的 OSA 风险与超声心动图（ECHO）参数与未辅助 HF 的初级保健个体的舒张功能障碍的相关性。
方法
一项横断面研究，共纳入 354 名（51%为女性）年龄在 45 岁或以上的个体。所有入选的个体均接受评估，包括以下程序：咨询、填写 BQ、临床检查、实验室检查和经胸多普勒超声心动图（TDE）。连续数据以中位数和四分位间距表示，分类变量以绝对和相对频率表示。与 OSA 风险相关的变量和在 0.05 水平上的变量整合了具有对数链接函数的伽马回归模型。p<0.05 被认为是统计学意义的指标。排除标准为存在 HF、填写 BQ 以及不符合其他标准的高血压和肥胖患者未被归类为 OSA 高风险。所有个体均在同一天接受以下程序的评估：就诊、BQ、实验室检查和 ECHO。
结果
在评估的 354 名个体中，63%被归类为 OSA 高风险。患有 OSA 高风险的患者舒张功能参数明显异常。在调整后，OSA 高风险与舒张功能指标如左心房容积指数（LAV-i）（p=0.02）、E'/A'（p<0.01）、A（p=0.02）、E/A（p<0.01）呈正相关且具有统计学意义。
结论
我们的数据表明，患有 OSA 高风险的患者 TDE 测量的舒张功能参数恶化。
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