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Evaluation of left ventricular function in obese patients with obstructive sleep apnea by three-dimensional speckle tracking echocardiography

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Abstract

Both obstructive sleep apnea(OSA) and obesity can cause myocardial remodeling and cardiac insufficiency via corresponding pathophysiological pathways. Therefore, it is speculated that the superposition of OSA and obesity may cause more severe impairment of cardiac function. The objective of our study was to evaluate the early changes of left ventricular systolic function in obese patients with OSA with three-dimensional speckle tracking echocardiography(3D-STE). This study was conducted with 33 obese OSA, 46 non-obese OSA, and 20 healthy subjects. Demographic, biochemical, and Polysomnography(PSG) data were collected, and their relation with the left ventricular strain was measured and analyzed with 3D-STE. The left ventricular strain was significantly worse in the OSA group compared to the control group(P < 0.05). The global longitudinal strain(GLS) was significantly worse obese group compared to non-obese OSA group (P < 0.05). The GLS value positively correlated with body mass index(BMI)(r = 0.406, P < 0.001), apnea–hypopnea index(AHI)(r = 0.610, P < 0.001)and homeostasis model assessment of insulin resistance(HOME-IR)(r = 0.431, P < 0.001) in patients with OSA, as well as high sensitivity C-reactive protein(hs-CRP)(r = 0.394, P < 0.001). Multiple linear regression analysis showed BMI and AHI were predictors of GLS. In OSA patients, the myocardial strain was impaired before the damages in left ventricular ejection fraction, suggesting that the left ventricular systolic function is damaged early. The coexistence of obesity and OSA can lead to severe impairment of cardiac function through mechanisms such as hypoxia and insulin resistance.

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All data generated or analyzed during this study are included in this published article and its supplementary information files.

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Authors and Affiliations

  1. Department of Cardiology, Peking University Third Hospital, Beijing, 100083, China

    Jingwen Zhao, Weihong Li & Yongzhen Zhang

  2. Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, 49 Huayuan North Road, Haidian District, Beijing, 100083, China

    Jianli Wang, Zixuan Hu, Yongwei Huang & Liqiang Zhang

Authors
  1. Jingwen Zhao
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  2. Weihong Li
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  3. Jianli Wang
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  4. Zixuan Hu
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  5. Yongwei Huang
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  6. Yongzhen Zhang
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  7. Liqiang Zhang
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Contributions

LZ and YZ put forwarded the idea for this article and guided the implementation of the whole project. WL and JW assisted with project implementation and patient enrollment, and Dr. WL performed echocardiographic measurements. ZH and YH were responsible for baseline data collection, PSG monitoring, and reporting analysis. JZ was responsible for data collection and analysis and wrote the article. Dr. LZ critically revised the work. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Liqiang Zhang.

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All the subjects had given their written informed consent.

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All the authors agreed to the publication of the manuscript.

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The Ethics Committee of Peking University Third Hospital approved this study (M2017152).

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Zhao, J., Li, W., Wang, J. et al. Evaluation of left ventricular function in obese patients with obstructive sleep apnea by three-dimensional speckle tracking echocardiography. Int J Cardiovasc Imaging 38, 2311–2322 (2022). https://doi.org/10.1007/s10554-022-02660-6

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  • DOI: https://doi.org/10.1007/s10554-022-02660-6

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