pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2015-25-6-698-703pulmo-648Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL STUDIESСтруктурно-функциональные показатели сердца у больных с синдромом обструктивного апноэ снаStructural and functional heart parameters in patients with obstructive sleep apnea syndromeПетросянМ. А.PetrosyanM. A.

к. м. н., врачпульмонолог, зав. лабораторией сна Медицинского центра «Измирлян»; тел.: (374) 93343559; факс: (374) 10242023

PhD, Head of Sleep Laboratory, “Izmirlyan” Medical Center; tel.: (374) 93343559; fax: (374) 10242023

laboratory_sleep@yahoo.comТовмасянН. Т.TovmasyanN. T.

к. м. н., врачкардиолог, зав. кардиологической службой Медицинского центра «Измирлян»; тел.: (374) 91018156; факс: (374) 10242023

PhD, Head of Cardiological Service, “Izmirlyan” Medical Center; tel.: (374) 91018156; fax: (374) 10242023

naira72@mail.ruНариманянМ. З.NarimanyanM. Z.

д. м. н., профессор кафедры семейной медицины Ереванского государственного медицинского университета им. М.Гераци; тел. / факс: (374) 10581794

MD, Professor at Department of Family Medicine, M.Geratsi Erevan State Medical University, tel. / fax: (374) 10581794

family_medus@yahoo.comМедицинский центр «Измирлян»: 0014; Республика Армения, Ереван, ул. Г.Нерсесяна, 19Россия“Izmirlyan” Medical Center: 19, G.Nersesyana str., Erevan, 0014, Republic of ArmeniaRussian FederationЕреванский государственный медицинский университет им. М.Гераци: 0025; Республика Армения, Ереван, ул. Корюна, 2РоссияM.Geratsi Erevan State Medical University: 2, Koryuna str., Erevan, 0025, Republic of ArmeniaRussian Federation201528022016256698703Copyright © Петросян М.А., Товмасян Н.Т., Нариманян М.З., 20162016Петросян М.А., Товмасян Н.Т., Нариманян М.З.Petrosyan M.A., Tovmasyan N.T., Narimanyan M.Z.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/648Цель

Цель. Изучение структурнофункциональных показателей сердца у пациентов с синдромом обструктивного апноэ сна (СОАС) по данным 2Dдопплерэхокардиографии.

Материалы и методы

Материалы и методы. В исследование включены больные c СОАС (n = 57) и практически здоровые лица (n = 22). Диагноз СОАС ставился посредством респираторной полиграфии при значении индекса апноэ / гипопноэ ≥ 15. Критериями исключения из исследования были: инфаркт миокарда в анамнезе, мерцательная аритмия, клапанная патология сердца, сердечная недостаточность, хроническая обструктивная болезнь легких, синдром гиповентиляции при ожирении, величина сатурации во время бодрствования < 90 % независимо от причины, а также наличие суперожирения (индекс массы тела ≥ 50). Больные были разделены на группы в соответствии со степенью тяжести СОАС и наличием или отсутствием артериальной гипертензии (АГ).

Результаты и обсуждение

Результаты и обсуждение. Продемонстрировано, что у пациентов с СОАС независимо от степени тяжести и наличия АГ наблюдается диастолическая дисфункция левого желудочка (ЛЖ) и гипертрофия обоих желудочков. При наличии СОАС тяжелой степени, помимо указанных изменений, отмечаются нарушение систолической функции ЛЖ, увеличение диаметра восходящей аорты и некоторое повышение систолического давления в правом желудочке.

Заключение

Заключение. В случае присоединения АГ к СОАС усугубляются изменения, имеющие место при СОАС. По мере увеличения частоты апноэ и десатурации во время сна структурнофункциональные показатели сердца ухудшаются.

The objective of this study was to investigate echocardiographic abnormalities in patients with obstructive sleep apnea syndrome (OSAS).

Methods

Methods. The study involved 57 patients with OSAS and 22 healthy control subjects. Respiratory polygraphy and 2D Doppler echocardiography were performed. Apnea/hypopnea index (AHI) was used to quantify the OSAS severity. Both morphology (wall thickness, diameters) and function (ejection fraction, fractional shortening, peak E and A wave velocities, mitral deceleration time) were assessed. Patients with comorbidities which were known to affect the heart structure and function excepting arterial hypertension were excluded from the study.

Results

Results. The results showed that OSAS was associated with left ventricular diastolic dysfunction, left and right ventricular hypertrophy independently of severity. Additionally, severe OSAS could cause the left ventricular systolic dysfunction, enlargement the ascending aorta diameter and mild increase in the right ventricular systolic pressure. Comorbod arterial hypertension could deteriorate these structural and functional abnormalities in patients with OSAS. With increase in frequency of apnea and desaturation during sleep, the heart structural and functional parameters worsen.

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The authors declare that there are no conflicts of interest present.