Zota Ioana Mădălina, Sascău Radu Andy, Stătescu Cristian, Tinică Grigore, Leon Constantin Maria Magdalena, Roca Mihai, Boișteanu Daniela, Anghel Larisa, Mitu Ovidiu, Mitu Florin
Department of Medical Specialties (I), Faculty of Medicine, Grigore T. Popa-University of Medicine and Pharmacy, 700115 Iasi, Romania.
Department of Surgical Specialties (I), Faculty of Medicine, Grigore T. Popa-University of Medicine and Pharmacy, 700115 Iasi, Romania.
Diagnostics (Basel). 2021 May 17;11(5):889. doi: 10.3390/diagnostics11050889.
Obstructive sleep apnea (OSA) is the most common form of sleep-disordered breathing, exhibiting an increasing prevalence and several cardiovascular complications. Continuous positive airway pressure (CPAP) is the gold-standard treatment for moderate-severe OSA, but it is associated with poor patient adherence. We performed a prospective study that included 57 patients with newly diagnosed moderate-severe OSA, prior to CPAP initiation. The objective of our study was to assess the impact of short-term CPAP on ventricular function in patients with moderate-severe OSA and cardiometabolic comorbidities. The patients underwent a clinical exam, ambulatory blood pressure monitoring and comprehensive echocardiographic assessment at baseline and after 8 weeks of CPAP. Hypertension, obesity and diabetes were highly prevalent among patients with moderate-severe OSA. Baseline echocardiographic parameters did not significantly differ between patients with moderate and severe OSA. Short-term CPAP improved left ventricular global longitudinal strain (LV-GLS), isovolumetric relaxation time, transmitral E wave amplitude, transmitral E/A ratio, right ventricular (RV) diameter, RV wall thickness, RV systolic excursion velocity (RV S') and tricuspid annular plane systolic excursion (TAPSE). Short-term CPAP improves biventricular function, especially the LV-GLS, which is a more sensitive marker of CPAP-induced changes in LV systolic function, compared to LVEF. All these benefits are dependent on CPAP adherence.
阻塞性睡眠呼吸暂停（OSA）是睡眠呼吸障碍最常见的形式，其患病率呈上升趋势，且伴有多种心血管并发症。持续气道正压通气（CPAP）是中重度OSA的金标准治疗方法，但患者依从性较差。我们进行了一项前瞻性研究，纳入了57例新诊断的中重度OSA患者，在开始使用CPAP之前。我们研究的目的是评估短期CPAP对中重度OSA合并心脏代谢疾病患者心室功能的影响。患者在基线时以及CPAP治疗8周后接受了临床检查、动态血压监测和全面的超声心动图评估。高血压、肥胖和糖尿病在中重度OSA患者中非常普遍。中重度OSA患者的基线超声心动图参数没有显著差异。短期CPAP改善了左心室整体纵向应变（LV-GLS）、等容舒张时间、二尖瓣E波振幅、二尖瓣E/A比值、右心室（RV）直径、RV壁厚度、RV收缩期偏移速度（RV S'）和三尖瓣环平面收缩期偏移（TAPSE）。短期CPAP改善了双心室功能，尤其是LV-GLS，与左心室射血分数（LVEF）相比，LV-GLS是CPAP引起的左心室收缩功能变化更敏感的指标。所有这些益处都依赖于CPAP的依从性。
