The Impact Of OSA On The Left Atrium And Ventricular In Patients With Ischemic Heart Disease

ObjectiveTo investigate the correlation of the left atrium,left ventricular and OSA in patients with ischemic heart disease,and further to evaluate the effect of OSA on the left atrium and ventricular.MethodsA total of 90 Patients with ischemic heart disease and OSA were enrolled in the study,including 46 patients with mild OSA(AHI<15/h)and 44 patients with moderate to severe OSA(AHI?15/h)based on the apnea hypopnea index(AHI).All the patients were required to accept The Apnealink and two-dimensional speckle tracking echocardiography(2DSTE)during the hospital stay.Indicators of the left atrium,left ventricular and OSA were meatured by 2DSTE and Apnealink,including the left atrial diameter(LAD),the interventricular septum diameter(IVsd),left ventricular posterior wall diameter(LVWPd),AHI and oxygen desaturation index(ODI),to evaluate the correlation of the left atrium and ventricular with AHI and the effect of OSA on them.ResultsThe age,BMI,current/former smoker,hypertension,diabetes mellitus,post-MI and length of stay were matched.The proportion of male in moderate to severe OSA group was higher relatively[(90.7%)&(69.6%),P < 0.05)].The oxygen desaturation index(ODI),apnea index(AI)and hypopnea index(HI)were significantly higher in moderate to severe OSA group[(29.75±13.11)&(5.87±5.21)/h;(24.00±14.10)&(2.46±2.38)/h;(9.10±5.68)&(5.33±2.57)/h,all P < 0.05].The lowest blood oxygen saturation(LSaO2)were significantly lower in moderate to severe OSA group[(80.52±5.79)&(85.37±7.20)%,P < 0.05].The left atrial diameter(LAD)and the left ventricular posterior wall diameter(LVWPd)were significantly higher in moderate to severe OSA group [(46.37 + 7.64)&(42.66 + 7.78)mm;(9.91 + 1.53)&(9.27 + 1.37)mm;all P < 0.05)].Pearson correlation analysis and multiple linear regression analysis indicated that AHI had a significant positive correlation with the left atrial diameter(LAD)and the left ventricular posterior wall diameter(LVWPd)(r = 0.243,r = 0.319,all p < 0.01).AHI was an independent parameter for increased LAD,LVWPd after adjusting for sex,age,BMI,current/former smoker,hypertension,diabetes mellitus,post-MI and left ventricular ejection fraction(LVEF).ConclusionSevere OSA can lead to an increase in left atrial diameter,left ventricular posterior wall diameter in patients with ischemic heart disease,indicating that OSA may cause the impairment of left heart structure.