LEFTWARD SHIFT OF THE INTERVENTRICULAR SEPTUM AND PULSUS PARADOXUS IN OBSTRUCTIVE SLEEP-APNEA SYNDROME
LEFTWARD SHIFT OF THE INTERVENTRICULAR SEPTUM AND PULSUS PARADOXUS IN OBSTRUCTIVE SLEEP-APNEA SYNDROME
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DOI：
10.1378/chest.100.4.894
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发表时间：
1991-10-01
期刊：
影响因子：
9.6
通讯作者：
SCHNITTGER, I
中科院分区：
文献类型：
--
作者：
SHIOMI, T;GUILLEMINAULT, C;SCHNITTGER, I
对10例确诊为阻塞性睡眠呼吸暂停综合征的患者进行了夜间胸骨旁长轴切面超声心动图检查。设计用于支撑超声心动图探头的工作台防止了监测期间的显著睡眠干扰，并允许在使用和不使用鼻腔CPAP治疗的情况下持续收集数据。在10名患者中，有5名患者在CPAP治疗前在NREM睡眠期间出现舒张性LSIVS，导致左心室变平。当LSIVS发生时，动脉血压记录显示出现反常脉搏。鼻腔CPAP使呼吸正常、通畅，PES最低点显著减少，LSIVS和反常脉搏消失。在一些OSAS患者中，左室后负荷增加和总外周阻力增加可导致肥厚和高血压。OSAS患者出现突触提示PES最低点明显增多，随着鼻腔CPAP的消失，可能是OSAS有效治疗的标志之一。
Echocardiograms were taken from the parasternal long axis view during nocturnal sleep in ten patients diagnosed with OSAS. A table designed to support the echocardiographic probe prevented significant sleep disturbances during monitoring and allowed continuous data collection with and without nasal CPAP administration. In five of ten patients, there was before CPAP treatment a diastolic LSIVS during NREM sleep, inducing a flattening of the left ventricle. Arterial blood pressure recordings showed pulsus paradoxus when LSIVS was occurring. Nasal CPAP led to normal, unobstructed breathing, significant decrease in Pes nadir and disappearance of LSIVS and pulsus paradoxus. Increase in left ventricular afterload and increase in total peripheral resistance could lead to hypertrophy and hypertension in some OSAS patients. The presence of pulsus paradoxus in OSAS indicates a marked increase in Pes nadir, and its disappearance with nasal CPAP may be one of the signs of effective treatment of OSAS.