Cardiac Function In Patients With Sleep Apnea Syndrome Was Assessed Using 3D-STI Technology

Objective:The cardiac function of patients with obstructive sleep apnea syndrome(OSAS)with normal left ventricular systolic function was evaluated using three-dimensional speckle tracking imaging(3D-STI),and the relationship between ventricular strain and sleep apnea was explored.Methods:Sixty patients with clinical diagnosis of OSAS were selected.According to the sleep apnea hypopnea index(AHI),AHI index obtained by the sleep respiration detector,they were divided into the mild group(AHI 5-15/h),the moderate group(AHI 16-30/h)and the severe group(AHI>30/h).20 patients in each group were selected.The left ventricle ejection fraction(LVEF),the right ventricle fractional area change(RVFAC)and tricuspid annular plane systolic excusion(TAPSE)of each group were measured by conventional ultrasound.Right ventricular Tei index was measured by tissue doppler imaging(TDI).3D-STI technology was applied to measure the overall left ventricular global longitudinal strain(LVGLS),left ventricular global circular strain(LVGCS),left ventricular global radial strain(LVGRS),left ventricular global area strain(LVGAS),and right ventricular global longitudinal strain(RVGLS),right ventricular global circular strain(RVGCS)and right ventricular global radial strain(RVGRS)of each group,and the differences of each parameter among each group were compared.Results:AHI in the OSAS patients increased significantly compared to the control group,and the difference was statistically significant(P<0.05),and increased gradually with the increase in disease severity.Comparison of 3D-STI strain parameters: compared with the control group,the 3D-STI strain parameters of the left and right ventricles of the OSAS patients were significantly reduced,and the difference was statistically significant(P<0.05).Compared with mild OSAS group,LVGLS and LVGAS were decreased in moderate and severe OSAS groups,and the difference was statistically significant(P<0.05).Compared with the moderate OSAS group,LVGLS,LVGCS,LVGRS and LVGAS in the severe group all decreased,and the difference was statistically significant(P<0.05).The partial strain parameters of the right ventricle changed earlier than that of the left ventricle.Comparison of routine parameters: compared with the control group,right ventricular Tei index increased significantly and TAPSE decreased significantly in the moderate and severe OSAS groups,and the difference was statistically significant(P<0.05).Compared with the mild OSAS group,the right ventricular Tei increased in the moderate OSAS group,and the right ventricular Tei increased and TAPSE decreased in the severe OSAS group,and the difference was statistically significant(P<0.05).Compared with the moderate OSAS group,the right ventricular Tei index increased and TAPSE decreased in the severe OSAS group,and the difference was statistically significant(P<0.05).Compared with each group,RVFAC and LVEF conventional parameters had no significant difference(P>0.05).Conclusions:The 3D-STI technique can be used to detect early left and right ventricular dysfunction before changes in patients’ left ventricular ejection fraction,providing a detailed basis for clinical early diagnosis,condition and prognosis evaluation.