Assessment Of Left Atrium Function In Patients With Obstructive Sleep Apnea Syndrome By Speckle Tracking Imaging

Objective Obstructive sleep apnea syndrome（OSAHS）is a potentially lethal sleep apnea disease,with a high incidence in the elderly.The aim of this study was to compare the left atrial function of patients with and without OSAHS by speckle tracking imaging（STI）,and to distinguish the left ventricular longitudinal myocardial function between OSAHS and healthy individuals.It is proved that the use of STI to assess the left atrial function of these patients can be early detection of left atrial remodeling and injury,is a safe and effective new way.Methods It is Included 90 cases of OSAHS patients and 30 cases of normal control group in this research.All subjects were subjected to polysomnography and echocardiography and spotted imaging,and OSAHS patients were mildly（AHI 5 to 15）,Moderate（AHI 16 to 30）and severe group（AHI greater than 30）according to apnea hypopnea index（the AHI）.In the breath state to obtain three consecutive cardiac cycle of the apical two-chamber,the apical four chamber dynamic images and stored.Using conventional Doppler echocardiog,M-ultrasonography,the color of Doppler and tissue Doppler measurement get Left ventricular septal thickness（IVSd）、Left ventricular posterior wall thickness（LVPWd）、Left ventricular end diastolic diameter（LVEDD）、Isometric diastolic time（IVRT）、Left ventricular ejection fraction（LVEF）、E peak/A peak of mitral valve flow spectrum（E/A）、E peak deceleration time（Dec T）、Mitral valve diastolic peak velocity（E）and mitral annulus diastolic early myocardial velocity（E/）ratio（E/E/）.Calculated data left ventricular mass index（LVMI）.Left ventricular maximum volume（LAVmax）,left atrial volume（LAVmin）,left atrial systolic volume（LAVIprep）were recorded and recorded using the area-length method in the apical four-chamber and two-chamber sections.Left ventricular maximum volume index（LAVImax）,left atrial minimum volume index（LAVImin）,and left atrial premature volume index（LAVIprep）were calculated using the left atrial volume divided by the body surface area.Then calculated according to a formula related to the left atrial total emptying fraction（LATEF）,passive emptying fraction（LAPEF）,active emptying fraction（LAAEF）and swelling index（LAEI）.Dynamic image transmission to the Q-LAB9.0 software for off-line analysis using speckle tracking technology to get left atrial strain and strain rate curve,recording of left ventricular systolic,diastolic early and late diastolic left atrial strain(LA_S-S,LA_S-E,LA_S-A)and strain rate(LA_SR-S,LA_SR-E,LA_SR-A).Results IVSd and LVPWd were increased from the moderate group,LVMI,IVRT and Dec T were statistically different between the OSAHS severe group and the healthy control group（P<0.05）.E/E/in the moderate group and severe group was higher than mild group and severe group increased more significantly（P<0.05）.Compared with the control group,LAVImax,LAVIP and LAVImin were significantly increased in OSAHS group,LAPEF decreased and LAAEF increased（P<0.05）.LA_S-E,LA_SR-E and LA_S-S,LA_SR-S decreased with the severity of OSAHS（P<0.05）,LAS-A,LA_SR-A increased slightly in the moderate group,LAS-A and LA_SR-A were significantly lower in OSAHS patients than in healthy controls（P<0.05）,but increased compared with healthy controls.Left atrial strain and strain rate within the test of the coefficient of variation-0.392-0.064,-0.188-0.019,the inter-test coefficient of variation between-0.257-0.039,-0.392-0.621.Conclusions OSAHS can aggravate the left heart’s burden,resulting in diastolic dysfunction,early can lead to left atrial remodeling,affecting left atrial function.STI in the assessment of left atrial function by sub clinical stage can be found in patients with OSAHS left atrial remodeling and damage,it can act as a left atrial function in a safe and effective way to assess reusable.