Comparison Of Heart Structure And Function Changes By Echocardiography In Patients With OSAHS With Or Without Hypertention

Objectives:To evaluate the heart structure and the function changes in patients with obstructive sleep apnea-hypopnea syndrome( OSAHS) in dependent from systemic hypertension( HT) and to determine the association between OSAHS severity and the heart structure and the function changes.Methods:The study population included 131 consecutive subjects; 31 of these patients had OSAHS, 38 of them had HT, but did not have OSAHS, 32 patients, who constituted the study group, had both disorders, and 30 subjects without any of these two disorders represented the control group. Heart structure and the function was assessed by echocardiography: standard two-dimensional, M-Mode, and conventional Doppler as well as tissue Doppler imaging. None of the Patients had a previous history of cardiac disease. The diagnosis of OSAHS was based on an apnea-hipopnea index of 5 or higher in polysomnography.Results:1. Cardiac structure: the interventricular septum(IVS), the left ventricle posterior wall(LVPW), left ventricular mass(LVM) and left ventricular mass index(LVMI)were significantly different in the patient groups(OSAHS, HT, OSAHS+HT) compared to the control group (P<0.05). IVS, LVPW and LVM were significant different between one another. The left atrium diastolic diameter(LA), the right ventricular diastolic diameter(RV), the arteriae aorta diameter (AO), the pulmonary artery diameter(PA), LVMI were significantly impaired in the OSAHS+HT group and the other 3 groups. the left ventricular diastolic diameter( LV), the right atrium diastolic diameter(RA) were significant difference between HT and OSAHS+HT group(P<0.05).2. Left ventricular function: There were not significant difference in strake volume(SV) and cardiac output(CO) among the four groups(.P>0.05). Left ventricular ejection fraction(LVEF), shortening fraction(FS) were significantly different in two OSAHS groups(OSAHS+HT and OSAHS) compared to the control group and HT group(P<0.05). E/A ratio was significantly different in OSAHS and HT groups compared to the control group. There was no significant difference between OSAHS+HT group and the control group.3. Tissue Doppler derived mitral annulus Em/Am ratio and early diastolic myocardial peak velocity(Em) of the left ventricle posterior wall were significantly different in the patient groups(OSAHS, HT, OSAHS+HT) compared to the control group(P<0.05). There were significant correlations both between OSAHS severity and the ventricular structure, and between diastolic parameters of the left ventricle.Conclusions:Both heart structure and function are changed in patients having OSAHS with or without HT. Mitral annulus Em/Am was found to be the parameter most closely related with OSAHS severity and the left ventricular subclinical dysfunction.