阻塞性睡眠呼吸暂停患者左室功能的早期改变  

Early left ventricular dysfunction in patients with newly diagnosed obstructive sleep apnoea

作　　者：王涛[1] 王志斌[1] 王艳丽[2] 

机构地区：[1]青岛大学附属医院心脏超声科,山东青岛266003 [2]山东省淄博市中心医院,山东淄博255000

出　　处：《医学影像学杂志》2017年第2期237-241,249,共6页Journal of Medical Imaging

摘　　要：目的评估初诊的左室射血分数正常的阻塞性睡眠呼吸暂停(OSA)患者左心室舒缩功能障碍。方法实验组包括125例患者,对照组包括78例年龄匹配的无心血管及呼吸系统疾病的健康志愿者。所有受试者进行多导睡眠图和组织多普勒成像检查。结果 OSA患者E/A比值和二尖瓣血流峰值E峰显著降低,A峰波二尖瓣血流显著升高,左心室等容舒张时间和二尖瓣口血流频谱显著增加。OSA患者二尖瓣后瓣组织多普勒衍生S’振幅、E’振幅及前瓣E’振幅显著减低。结论左心室整体功能正常的新确诊的OSA患者,其左心室舒张功能及区域纵向收缩功能已明显受损。Objective To evaluate whether obstructive sleep apnea （OSA） contributes directly to left ventricular （LV） dias- tolic and regional systolic dysfunction in newly diagnosed OSA with normal left ventricle ejection fraction. Methods 125consecutive patients were prospectively enrolled in the study. Control group consisted of 78 asymptomatic age-matched healthy subjects who did not have any cardiovascular and respiratory diseases. All patients had undergone overnight polysomnography and standard transthoracic and tissue Doppler imaging eehocardiogram. Results The E/A ratio and the peak E wave at mitral flow were significantly lower and the peak A wave at mitral flow was significantly higher in OSA patients compared with control sub- jects. Left ventricle isovolumetric relaxation time （IVRT） and mitral valve flow propagation （MVFP） were significantly longer in OSA patients than in controls. Tissue Doppler derived S＇ amplitude of lateral part at mitral valve （ S＇ Lm） and E＇ wave ampli- tudes both at the lateral （E＇ Lm） and septal parts of the mitral valve （S＇ Sin） were significantly lower in OSA patients compared to controls. Conclusion Newly diagnosed OSA patients with normal global LV function have significantly impaired diastolic func- tion and regional longitudinal systolic function. OSA is independently associated with these changes in LV function.

关 键 词：阻塞性睡眠呼吸暂停综合征 左心室功能 组织多普勒 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541.5[医药卫生—诊断学]