Impact of obstructive sleep apnea on right ventricular global function:: Sleep apnea and myocardial performance index
Impact of obstructive sleep apnea on right ventricular global function:: Sleep apnea and myocardial performance index
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DOI：
10.1159/000085369
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发表时间：
2005-01-01
期刊：
影响因子：
3.7
通讯作者：
Kiliç, M
中科院分区：
文献类型：
--
作者：
Dursunoglu, N;Dursunoglu, D;Kiliç, M
背景：阻塞性睡眠呼吸暂停综合征(OSA)以睡眠时反复上呼吸道阻塞为特征，可引起心力衰竭、心律失常、心肌梗死、全身和肺高压等心血管并发症。目的：测定无合并症阻塞性睡眠呼吸暂停综合征(OSA)患者的右室内径和反映心功能的心肌功能指数(MPI)。方法：49名无高血压、糖尿病或任何心脏或肺部疾病的受试者接受夜间多导睡眠图和完整的超声心动图检查。根据睡眠呼吸暂停指数(AHI)将受试者分为3组：对照组(AHI+lt；5，n=20)，轻度OSA组(AHI：5~14，n=11)，中-重度OSA组(AHI 6~15，n=18)。M型超声测量右室游离壁内径，计算右室MPI为(等容收缩时间+等容松弛时间)/肺射血时间。结果：两组在年龄、体重指数、心率、收缩压和舒张压方面差异无统计学意义(p>；0.05)。右室舒张末和收缩末期内径在两组间无统计学差异，均在正常范围内。对照组、轻度OSA组和中重度OSA组的右室游离壁内径差异无统计学意义(6.7+/-0.9，6.9+/-1.0，7.1+/-1.1 mm，p>；0.05)。右室舒张期功能不全仅见于第3组。3组右室心肌梗死指数(0.6 2+/-0.18)显著高于2组(0.5 0+/-0.10)和1组(0.48+/-0.0 8，p<；0.001)。结论：中重度阻塞性睡眠呼吸暂停患者除存在舒张期功能障碍外，还存在右室整体功能障碍。版权所有(C)2005 S.Karger AG，巴塞尔。
Background: Obstructive sleep apnea (OSA) is characterized by repetitive upper airway obstructions during sleep, and it might cause cardiovascular complications such as heart failure, arrhythmias, myocardial infarction, systemic and pulmonary hypertension. Objectives: To determine right ventricular diameters and myocardial performance index (MPI) reflecting ventricular global function in uncomplicated OSA patients. Methods: 49 subjects without hypertension, diabetes mellitus, or any cardiac or pulmonary disease referred for evaluation of OSA had overnight polysomnography and complete echocardiographic assessment. According to the apneahypopnea index (AHI), subjects were divided into three groups: group 1: control subjects ( AHI < 5, n = 20), group 2: patients with mild OSA ( AHI: 5 - 14, n = 11), and group 3: moderate-severe OSA ( AHI 6 15, n = 18). Right ventricular free wall diameter was measured by M mode, and right ventricular MPI was calculated as (isovolumic contraction time + isovolumic relaxation time)/ pulmonary ejection time. Results: There were no differences of age, body mass index, heart rates, systolic and diastolic blood pressures among the groups ( p > 0.05). Right ventricular end-diastolic and end-systolic diameters were not statistically different between the groups, and were within normal limits. Also, right ventricular free wall diameter was not significantly different between the groups of control, mild OSA and moderate-severe OSA (6.7 +/- 0.9, 6.9 +/- 1.0, 7.1 +/- 1.1 mm, p > 0.05). Right ventricular diastolic dysfunction was shown only in group 3 patients. Right ventricular MPI was statistically higher in group 3 (0.62 +/- 0.18) than in group 2 patients (0.50 +/- 0.10), and group 1 patients (0.48 +/- 0.08, p < 0.001). Conclusions: It was suggested that patients with moderate-severe OSA had a right ventricular global dysfunction, in addition to the presence of a diastolic dysfunction. Copyright (C) 2005 S. Karger AG, Basel.