| Objective The aim of this study is to evaluate the right ventricular systolic function in patients with obstructive sleep apnea Hypopnea syndrome(OSAHS)and chronic obstructive pulmonary disease(COPD)by two-dimensional speckle tracking imaging(2D-STI).Methods A total of 84 patients with OSAHS were collected and divided into two groups according to whether they were complicated with COPD.42 patients were divided into two groups: OSAHS group(n = 42)and control group(n = 42).42 healthy adults were selected as normal control group.All images were collected and measured by IE33 ultrasound diagnostic instrument.The right ventricular anterior wall thickness(RVAM)and right ventricular end-diastolic diameter(RVDD)were measured by conventional ultrasound,and then the apical four-chamber cardiac images were collected and imported into Q-lab workstation and analyzed by 2D-STI software.The peak systolic velocities of basal segment,middle segment and apical segment of right ventricular free wall,peak systolic strain and systolic peak strain rate were compared among the above three groups.Results 1.General data comparison There was no significant difference in heart rate,age,diastolic pressure and systolic blood pressure between the four groups(P>0.05).AHI was significantly different between OSAHS group and control group,OSAHS+COPD group and control group(P<0.05),and body mass index(BMI)in OSAHS+COPD group and control group.There was a statistically significant difference between groups(P<0.05).The lowest arterial oxygen saturation(LSa O2)was significantly different between OSAHS group and control group,OSAHS+COPD group and control group,OSAHS+COPD group and OSAHS group(P<0.05).2.Comparison of conventional Ultrasonic Measurement Indexes Compared with the normal group,there were significant differences in PASP,TAPSE and FAC between OSAHS and COPD patients(P<0.05).Compared with the OSAHS group,the difference of the pulmonary artery systolic pressure between the OSAHS and COPD patients was statistically significant(P<0.05)..3.Comparison of 2D-STI values(1)Comparing the Vs、S、SRs of the right ventricle free wall’s basal segment in all groups Compared with the control group,there was a significant difference in the SRs between the OSAHS group and the OSAHS+COPD group in the basal segment of the free wall of the right ventricle(P < 0.05).There was a significant difference between the OSAHS group and the OSAHS+COPD group(P < 0.05),and there was a significant difference between the other groups(P < 0.05).The difference of 2 D-STI parameters was not statistically significant(P > 0.05).(2)Comparing the Vs、S、SRs of the right ventricle free wall’s middle segment in all groups Compared with the control group,there were significant differences in SRs between the OSAHS group and the OSAHS group in the middle segment of the free wall of the right ventricle(P< 0.05).Compared with OSAHS alone,there was a significant difference in Vs and S in the middle segment of the right ventricular free wall between the OSAHS+COPD group and the control group(P< 0.05).There was no significant difference in 2D-STI parameters between other groups(P > 0.05).(3)Comparing the Vs,S,SRs of the right ventricular free wall’s apical segment in all groups Compared with the control group,the Vs,S and SRs of the right ventricular free wall in OSAHS group and OSAHS+COPD group were statistically different(P<0.05),and there was no significant difference in 2D-STI parameters between the rest groups(P >0.05).Conclusions 1.There was a decrease in right ventricular systolic function in patients with OSAHS alone and OSAHS+COPD,and the function of right ventricular damage in patients with OSAHS+COPD was more severe than that in patients with OSAHS alone.2.2D-STI is sensitive and accurate in detecting the changes of right ventricular systolic function in patients with OSAHS+COPD,and provide help for clinical diagnosis,treatment and prevention... |
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