Effects Of Obstructive Sleep Apnea Hypopnea Syndrome On Cardiac Structure And Function In Patients With Heart Failure With Preserved Ejection Fraction

Objective:To investigate the effect of obstructive sleep apnea hypopnea syndrome（OSAHS）on cardiac structure and function in patients with heart failure with preserved ejection fraction（HFPEF）.Method:The target is the HFPEF patient who was admitted to the Department of Cardiology,a 3 A grade hospital from October 2016 to September 2018,A total of 68cases of OSAHS diagnosed by polysomnography,worked as a group with HFPEF and OSAHS;at the same time,patients with no OSAHS matched with age,gender,and accompanying disease were used as a control group（n=68）.Baseline data of enrolled patients includes age,gender,concomitant disease,body mass index（BMI）,smoking history,New York Heart Association（NYHA）cardiac function grading.Sleep breathing was monitored and the following information was recorded:apnea hypopnea index（AHI）,mean pulse oxygen saturation（MSaO₂）,and lowest pulse oxygen saturation（LSaO₂）;the serum NT-proBNP level and 6MWT results should be assayed.The M-mode two-dimensional echocardiography was recorded as follows:LVIDD,LA,IVST,LVPWT,EDV and ESV.Calculate LVEF,and Doppler Ultrasound Measurements including E peak,A peak,E/A,E/e’.The measurement data were expressed by（`x±s）,and the t-test was used to compare between groups;the count data was expressed by the composition ratio or rate,and the chi-square test was used for comparison between groups.The difference was statistically significant at the test level P<0.05.Result:Baseline data comparison::there were no statistical differences in gender,age,smoking history,NYHA cardiac function grading,and accompanying disease between the two groups（P>0.05）,and BMI was statistically different（P<0.05）;Comparison of sleep respiration monitoring indicators:AHI,MSaO₂,LSaO₂ were significantly different between the two groups（P<0.05）;Comparison of cardiac structure:there was significant difference in IVST,LVPWT and LA between groups（P<0.05）;Comparison of left ventricular diastolic function:LVIDD,EDA,E/e’,E/A were statistically different between groups（P<0.05）;Comparison of cardiac function indicators:there was no significant difference in NT-proBNP between the groups（P>0.05）,and the 6MWT distance was statistically different（P<0.05）.Conclusion1.Compared with the control group,the left ventricular hypertrophy and left atrial enlargement of HFPEF combined with OSAHS group were more distinct;2.Patients with HFPEF combined with OSAHS have more severe left ventricular diastolic dysfunction than patients with HFPEF alone;3.OSAHS aggravates cardiac dysfunction in patients with HFPEF and reduces exercise tolerance;4.Obesity is a risk factor for OSAHS;5.HFPEF patients often combine multiple diseases at the same time.Coronary heart disease and hypertension are the most common primary diseases.