Evaluation of left ventricular diastolic functions in patients with obstructive sleep apnea with tissue Doppler echocardiography and pulmonary vein diastolic flow rates

Yıl 2020, Cilt: 2 Sayı: 3, 61 - 67, 28.06.2020

Yücel Yılmaz İsmet Sarıkaya Namık Kemal Eryol

https://doi.org/10.38053/acmj.718110

Öz

Objective: To
evaluate left ventricular (LV) diastolic functions in patients with obstructive
sleep apnea syndrome (OSAS) using pulmonary vein diastolic flow Doppler (PVDD)
technique and tissue Doppler echocardiography (DDE) technique.

Material
and Method; Forty patients, who were diagnosed as OSAS with
polysomnography and have not yet been treated, and 28 healthy individuals were
included in the study. Patients underwent PVDD and DDE examinations.

Results;
There was no statistically difference between the groups in terms of LV
systolic and diastolic diameters and ejection fractions obtained by M-mode
measurements. Decreased early diastolic Ea-m wave velocities and Ea-m / Aa-m
rates of septal and lateral annulus (p <0.001 and p <0.001, respectively)
in cases with OSAS, examined in LV, Aa-m wave wave for late diastolic filling
an increase in speed was observed (p <0.05). There was no change in systolic
wave velocities obtained from lateral and septal wall. No relation was found
between apnea-hypopnea index and LV DDE parameters. Pulmonary vein systolic
wave (PVs) was found higher in the control group, while pulmonary vein
diastolic wave (PVd) was higher in patients with OSAS, although not
statistically significant (p> 0.05). Although PVs / PVd ratio was greater than
1 in both groups, it was found lower in patients with OSAS (p <0.05).
Pulmonary vein atrial wave (PVa) was significantly higher in patients with
OSAS.

Conclusion:
OSAS is a condition that impairs LV diastolic functions, regardless of the
severity of the disease, even if there is no underlying heart disease.
Pulmonary vein Doppler and tissue Doppler echocardiography can be used to
evaluate left ventricular diastolic dysfunction.

Anahtar Kelimeler

obstructive sleep apnea syndrome, echocardiography, left ventricular diastolic function

Obstrüktif uyku apne sendromunda sol ventrikül diyastolik fonksiyonlarının doku Doppler ekokardiyografi ve pulmoner ven diyastolik akım hızları ile değerlendirilmesi

Öz

Amaç; Obstrüktif uyku apne sendromu (OUAS) olan hastalarda, pulmoner ven
diyastolik akım Doppler (PVDD) tekniği ve doku Doppler ekokardiyografi (DDE)
tekniği kullanılarak sol ventrikül (SV) diyastolik fonksiyonlarının
değerlendirilmesidir.

Gereç ve Yöntem: Çalışmaya polisomnografi ile OUAS tanısı konulan
ve henüz tedavi uygulanmamış 40 hasta ve 28 sağlıklı birey kontrol grubu olarak
alındı. Hastalara PVDD ve DDE incelemesi yapıldı.

Bulgular: Gruplar arasında M-mode ölçümleri ile elde edilen SV sistolik ve
diyastolik çapları, ejeksiyon fraksiyonları açısından fark saptanmadı. OUAS’ li
olgularda SV’ de incelenen septal ve lateral anulusa ait erken diyastolik Ea-m
dalga hızlarında ve Ea-m/Aa-m oranlarında azalma (sırasıyla p<0.001 ve
p<0.001), geç diyastolik doluma ait Aa-m dalga dalga hızlarında artma
gözlendi (p<0,05). Lateral ve septal duvardan elde edilen sistolik dalga
hızlarında değişiklik saptanmadı. Apne-hipopne indeksi ile SV DDE parametreleri
arasında ilişki saptanmadı. Pulmoner ven sistolik dalgası (PVs) kontrol
grubunda, Pulmoner ven diyastolik dalgası (PVd) ise OUAS’ li hastalarda
istatiksel olarak anlamlı olmasa da daha yüksek tespit edildi(p>0,05).
PVs/PVd oranı her iki grupta da 1’den büyük olmakla birlikte, OUAS’ li
hastalarda daha düşük bulundu(p<0,05). Pulmoner ven atriyal dalgası (PVa)
ise OUAS’ li hastalarda anlamlı olarak daha yüksek saptandı.

Sonuç: OUAS, altta yatan herhangi bir kalp hastalığı olmasa da hastalığın
şiddetinden bağımsız olarak SV diyastolik fonksiyonlarını bozan bir durumdur.
Sol ventrikül diyastolik disfonksiyonun değerlendirilmesi için pulmoner ven
Doppler ve doku Doppler ekokardiyografi kullanılabilir.

Anahtar Kelimeler

; obstrüktif uyku apne sendromu, ekokardiyografi, sol ventrikül diyastolik fonksiyonlar

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