斑点追踪和实时三维超声心动图联合评估阻塞性睡眠呼吸暂停综合征患者左房容积和功能的效果  

Evaluation of left atrial volume and function in patients with obstructive sleep apnea using speckle tracking imaging and real-time three-dimensional echocardiography

作　　者：万泉[1] 邢雨蒙 李善群[1] 潘翠珍[1] WAN Quan;XING Yu-meng;LI Shan-qun;PAN Cui-zhen(Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai 200032, China)

机构地区：[1]复旦大学附属中山医院心脏超声科,上海200032

出　　处：《中国临床医学》2021年第2期230-235,共6页Chinese Journal of Clinical Medicine

基　　金：上海市科学技术委员会科研计划项目(18ZR1436100).

摘　　要：目的:联合斑点追踪(STI)和实时三维超声心动图(RT-3DE)评估阻塞性睡眠呼吸暂停综合征(OSAS)患者左房(LA)容积和功能的早期变化。方法:纳入92例中重度[呼吸暂停低通气指数(AHI)>15次/h]OSAS患者和50例健康人。根据左室质量指数(LVMI)将OSAS患者分为2个亚组:左室肥厚(LVH)组(n=30)、非LVH组(n=62)。所有受试者均接受常规超声心动图检查,并结合STI和RT-3DE进行左房功能评估。结果:与对照组相比,OSAS患者的左房整体纵向应变在舒张早期(LA S-E)和收缩期(LA S-S)受损,但在舒张末期(LA S-A)增加(P<0.05)。LVH组患者的LA S-S和LA S-E低于非LVH组(P<0.05)。RT-3DE获得的参数提示,左房收缩前容积(LAVIpreA)、最小容积(LAVImin)在对照组、非LVH组和LVH组间依次增加(P<0.05)。在OSAS患者中,AHI与LA S-S、LA S-E、LAVImax、LAVIpreA、LAVImin、左房总排空容积指数(LATEVI)和左房主动排空容积指数(LAAEVI)密切相关。结论:STI和RT-3DE联合可用于评估OSAS患者左房容积和功能的早期变化;随着LVH和OSAS的进展,左房功能损伤进一步加重。Objective:To evaluate the early changes of left atrial(LA)volume and function by speckle tracking imaging(STI)and real-time three-dimensional echocardiography(RT-3DE)in patients with obstructive sleep apnea syndrome(OSAS).Methods:A total of 92 patients with moderate to severe OSAS(apnea-hypopnea index[AHI]>15/h)and 50 healthy people were prospectively included.According to the left ventricular mass index(LVMI),OSAS patients were stratified into two groups:30 patients with left ventricular hypertrophy(LVH)and 62 patients without LVH.All subjects were assessed for LA function through conventional echocardiography combined with STI and RT-3DE.Results:OSAS patients showed lower LA global longitudinal strain during early diastole(LA S-E),systole(LA S-S),while higher strain during late diastole(LA S-A)than controls(P<0.05).While OSAS patients with LVH had lower LA S-S,LA S-E and higher LA S-A than patients without LVH(all P<0.05).RT-3DE results should that LA volume before systole(LAVIpreA),and minimum volume(LAVImin)were significantly higher in OSAS patients(P<0.05).The AHI was correlated with LA S-S,LA S-E,LAVImax,LAVIpreA,LAVImin,LATEVI,LAAEVI in OSAS patients.Conclusions:The combination of STI and RT-3DE can evaluate the early changes of LA volume and function in patients with OSAS.With the progress of LVH and OSAS,LA function damage will be further aggravated.

关 键 词：阻塞性睡眠呼吸暂停 斑点追踪 超声心动图 左房 

分 类 号：R540.4+5[医药卫生—心血管疾病]