背景:最近的研究表明,右心房(RA)功能是心血管疾病发病率和死亡率的重要预测因子。然而,关于阻塞性睡眠呼吸暂停综合征(OSAS)患者RA相位功能的研究数据很少,尤其是基于左心室的几何形状.所以,我们旨在通过多模式超声心动图评估OSAS患者左心室几何形状对RA分期功能的影响.
方法:本横断面研究共纳入235例OSAS患者,多导睡眠图,和超声心动图检查。根据左心室质量指数(LVMI)和相对壁厚(RWT)将OSAS患者分为四组:正常几何形状(NG),同心重塑(CR),同心肥大(CH),和偏心肥大(EH)。通过多模态超声心动图方法(二维超声心动图双平面法[2DE];二维斑点追踪超声心动图[2D-STE];和三维超声心动图[3DE])评估RA的相位功能。多元线性回归分析用于确定左心室几何形状与RA相位功能之间的关系。
结果:RA体积和指数从NG到CR再到EH再到CH增加。收缩期RA总排空分数和RA应变从NG到CR再到EH再到CH降低。舒张早期RA被动排空分数和RA应变类似地降低。舒张后期RA活性排空分数和RA应变也逐渐增加。在根据性别进行调整的分析中,年龄,身体质量指数,收缩压,呼吸暂停低通气指数,LVMI,肺动脉收缩压,和右心室游离壁厚度,CH通过2DE面积-长度法与RA储层和导管功能相关,而CH和EH通过2D-STE和3DE方法与RA储层和导管功能相关。Further,CH通过2DE面积长度法与RA增压泵功能相关,2D-STE,和3DE方法。
结论:通过多模态超声心动图方法,RA体积和相位功能随左心室几何形状而变化。CH对RA分期功能有明显的负面影响。
BACKGROUND: Recent studies have shown that right atrial (RA) function are important predictors of cardiovascular morbidity and mortality. However, the
study data about RA phasic function in obstructive sleep apnea syndrome (OSAS) patients are scarce, especially based on the left ventricular geometry. So, we aimed to assess the influence of left ventricular geometry on RA phasic function in OSAS patients via a multimodal echocardiographic approach.
METHODS: Total of 235 OSAS patients were enrolled in this cross-section
study and underwent complete clinical, polysomnography, and echocardiography examinations. The OSAS patients were divided into four groups based on left ventricular mass index (LVMI) and relative wall thickness (RWT): normal geometry (NG), concentric remodeling (CR), concentric hypertrophy (CH), and eccentric hypertrophy (EH). RA phasic function was evaluated via multimodal echocardiography approach (two-dimensional echocardiography biplane method [2DE]; two-dimensional speckle-tracking echocardiography [2D-STE]; and three-dimensional echocardiography [3DE]). The multiple linear regression analysis was used to determine the relationship between left ventricular geometry and RA phasic function.
RESULTS: The RA volume and indices increased from NG to CR to EH to CH. RA total emptying fraction and RA strain during systole decreased from NG to CR to EH to CH. RA passive emptying fraction and RA strain during early diastole similarly decreased. RA active emptying fraction and RA strain during late diastole also gradually increased similarly. In analyses that adjusted for gender, age, body mass index, systolic blood pressure, apnea-hypopnea index, LVMI, systolic pulmonary artery pressure, and right ventricular free wall thickness, CH was associated with RA reservoir and conduit function via 2DE area-length method, whereas CH and EH were associated with RA reservoir and conduit function via 2D-STE and 3DE method. Further, CH was associated with RA booster pump function via 2DE area-length method, 2D-STE, and 3DE method.
CONCLUSIONS: The RA volumes and phasic function varied with left ventricular geometry via multimodal echocardiography approach. CH had the apparent negative effect on RA phasic function.