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自动应变左心室技术是检测阻塞性睡眠呼吸暂停综合征患者亚临床左心室功能障碍的一种敏感方法。

The AutoStrain LV technique is a sensitive method for detecting subclinical left ventricular dysfunction in patients with obstructive sleep apnea syndrome.

作者信息

Zhang Yi, Zhu Shangyong

机构信息

Department of Medical Ultrasound, First Affiliated Hospital of Guangxi Medical University, Nanning, China.

出版信息

Medicine (Baltimore). 2025 May 2;104(18):e42309. doi: 10.1097/MD.0000000000042309.

Abstract

Obstructive sleep apnea syndrome (OSAS) is strongly associated with multiple cardiovascular diseases, however, early detection of subclinical myocardial damage is a challenge. We aimed to compare the sensitivity of AutoStrain LV technology versus conventional echocardiography for assessing left ventricular (LV) impairment in patients with subclinical OSAS and to identify sensitive echocardiographic indicators of LV injury. Classifying 126 qualified participants based on their apnea-hypopnea index (AHI), we formed control, mild, moderate, and severe OSAS categories. LV global longitudinal strain (LVGLS) was evaluated by AutoStrain LV technique. Conventional two-dimensional echocardiography was used to measure different factors including LV end-diastolic diameter, LV end-systolic diameter, interventricular septum diameter, LV posterior wall diameter, and LV functional shortening. LV ejection fraction was calculated by modified biplane Simpson method, and the Doppler ultrasound was used to measure the LV diastolic function indices E/A and E/E'. We calculated the correlations between these ultrasound parameters and the AHI. Although LV ejection fraction and LV functional shortening are normal, the LVGLS in the OSAS group decreased with the severity of the disease (P < .001). The values of E/A in the mild, moderate, and severe OSAS groups, as well as the values of E/E' in the mild and severe OSAS groups, showed significant differences compared to the control group, but no significant differences were found between different OSAS subgroups. The IVST and LVPWT values in the moderate and severe OSAS groups were higher than those in the control group and mild OSAS group, but there were no significant differences between the other groups. Conventional echocardiographic parameters did not change with the severity of the disease. Correlation analysis showed that LVGLS had the strongest correlation with AHI (r = -0.732, P < .001). Compared with conventional echocardiography, AutoStrain LV technology has a higher sensitivity for monitoring LV function impairment in patients with subclinical OSAS.

摘要

阻塞性睡眠呼吸暂停综合征(OSAS)与多种心血管疾病密切相关,然而,亚临床心肌损伤的早期检测是一项挑战。我们旨在比较AutoStrain LV技术与传统超声心动图在评估亚临床OSAS患者左心室(LV)损伤方面的敏感性,并确定LV损伤的敏感超声心动图指标。根据呼吸暂停低通气指数(AHI)对126名合格参与者进行分类,我们形成了对照组、轻度、中度和重度OSAS类别。通过AutoStrain LV技术评估左心室整体纵向应变(LVGLS)。使用传统二维超声心动图测量不同因素,包括左心室舒张末期内径、左心室收缩末期内径、室间隔直径、左心室后壁直径和左心室功能缩短率。采用改良双平面Simpson法计算左心室射血分数,并使用多普勒超声测量左心室舒张功能指标E/A和E/E'。我们计算了这些超声参数与AHI之间的相关性。尽管左心室射血分数和左心室功能缩短率正常,但OSAS组的LVGLS随疾病严重程度降低(P < 0.001)。轻度、中度和重度OSAS组的E/A值以及轻度和重度OSAS组的E/E'值与对照组相比有显著差异,但不同OSAS亚组之间未发现显著差异。中度和重度OSAS组的室间隔厚度(IVST)和左心室后壁厚度(LVPWT)值高于对照组和轻度OSAS组,但其他组之间无显著差异。传统超声心动图参数未随疾病严重程度而变化。相关性分析表明,LVGLS与AHI的相关性最强(r = -0.732,P < 0.001)。与传统超声心动图相比,AutoStrain LV技术在监测亚临床OSAS患者左心室功能损害方面具有更高的敏感性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b212/12055174/835b668fdfd9/medi-104-e42309-g001.jpg

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