应用二维斑点追踪技术评估阻塞性睡眠呼吸暂停综合征患者右心室功能被引量：1

Evaluation of right ventricular function in patients with obstructive sleep apnea syndrome by two-dimensional speckle tracking imaging

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摘要目的 :应用二维斑点追踪技术(2D-STI)技术评价阻塞性睡眠呼吸暂停综合征(OSAS)患者右心室收缩功能的改变。方法:纳入经多导睡眠监测确诊OSAS患者49例为OSA组,根据睡眠呼吸暂停低通气指数(AHI)进行分度,轻度12例,中度9例,重度28例,同期选择年龄、性别相匹配无打鼾史的健康志愿者40例为对照组。应用常规超声心动图和2D-STI技术测量所有受试者的超声心动图参数,比较两组参数的差异。结果:与对照组相比,OSA组右房容积指数(RAVI)显著增大(P=0.04),三尖瓣口舒张晚期血流峰值速度(A-tv)显著升高(P=0.025),三尖瓣口舒张早期血流峰值速度/三尖瓣口舒张晚期血流峰值速度(E/A)减低(P=0.047),组织多普勒(TDI)三尖瓣环舒张早期峰值速度(Ea)显著减低(P=0.014)。OSA组右心室整体纵向应变(RV-GLS)(P=0.036)和右心室游离壁纵向应变(RV-FWLS)(P=0.039)显著减低。轻中度组与重度组比较,重度组RV-GLS(P=0.002)、RV-FWLS(P=0.030)显著减低,重度组RVFW基底段纵向应变(P=0.033)、心尖段纵向应变(P=0.028)显著减低,两组RVFW中间段纵向应变差异无统计学意义(P>0.05)。结论:OSAS患者右心室舒张和收缩功能均出现异常改变,2D-STI可早期发现OSAS患者右心室收缩功能的改变,且随着病情严重程度的增加,收缩功能呈减低趋势,右心室纵向应变可作为临床重要的参数,为临床治疗和预后提供有价值的信息。 Objective:To evaluate the changes of right ventricular systolic function in patients with obstructive sleep apnea syndrome(OSAS)using the two-dimensional speckle tracking imaging(2D-STI)technique.Methods:Forty-nine patients with OSAS diagnosed by polysomnography were divided as the OSA group.Based on the sleep AHI,there were 12 cases classified as mild,9 as moderate,and 28 as severe.Forty healthy volunteers with matching age and gender and without a history of snoring were selected as the control group.They underwent conventional echocardiography and 2D-STI to complete the analysis of right ventricular,and variables were compared between the two groups.Results:Compared with the control group,the OSA group showed significantly higher right atrial volume index(RAVI)(P=0.04),and the peak of late diastolic flow velocity of tricuspid orifice(A-tv)was significantly increased(P=0.025).The value of E/A was decreased(P=0.047),and early peak diastolic velocity(Ea)of tricuspid annulus by TDI was significantly decreased(P=0.014).The global longitudinal strain of right ventricle(RV-GLS)(P=0.036)and longitudinal strain of right ventricular free wall(RV-FWLS)(P=0.039)in the OSA group were significantly reduced.Compared to the mild and moderate OSA,RV-GLS of the severe OSA showed a notable reduction(P=0.002),as well as RV-FWLS(P=0.030).Meanwhile RVFW basal longitudinal strain(P=0.033)and apex longitudinal strain(P=0.028)of severe OSA were significantly reduced,and RVFW middle longitudinal strain was not significantly different between two groups(P>0.05).Conclusion:The diastolic and systolic functions of right ventricular are changed in patients with OSAS.2D-STI can detect the changes in right ventricular systolic function at an early stage,related to the severity of the syndrome.RVLS can be used as an important clinical parameter and provides valuable information for clinical treatment and prognosis.

作者许丹王华霍换换韩东刚周琦孙蕾 XU Dan;WANG Hua;HUO Huan-huan;HAN Dong-gang;ZHOU Qi;SUN Lei(Department of Ultrasound,Second Affiliated Hospital,Xi’an Jiaotong University,Xi’an 710004,China)

机构地区西安交通大学第二附属医院医用超声研究室

出处《中国临床医学影像杂志》 CAS CSCD 北大核心 2024年第2期96-99,共4页 Journal of China Clinic Medical Imaging

基金中央高校基本科研业务费专项资金资助(xzy012021059)。

关键词睡眠呼吸暂停阻塞性心室功能右超声心动描记术 Sleep Apnea,Obstructive Ventricular Function,Right Echocardiography

分类号 R322.11 [医药卫生—人体解剖和组织胚胎学] R540.45 [医药卫生—心血管疾病]

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