Speckle tracking echocardiography in chronic obstructive pulmonary disease and overlapping obstruc☆tive sleep apnea
Carmen Pizarro 1, Fabian van Essen 1, Fabian Linnhoff 1, Robert Schueler 1, Christoph Hammerstingl 1, Georg Nickenig 1, Dirk Skowasch 1, Marcel Weber 1Affiliations expand
- PMID: 27536094
- PMCID: PMC4976816
- DOI: 10.2147/COPD.S108742
Free PMC article
Abstract
Background: COPD and congestive heart failure represent two disease entities of growing global bur&den that share common etiological features. Therefore, we aimed to identify the degree €of left ventricular (LV) dysfunction in COPD as a function of COPD severity ∑stages and concurrently placed particular emphasis on the presence of ov™erlapping obstructive sleep apnea (OSA).
Methods: A total of 85 COPD outpatients (64.1±10.4 years, 54.1% males) and 20 controls, matched for age, sex, and smoking habits, underwent speckle tracking echocardiogrδaphy for LV longitudinal strain imaging. Complementary 12-lead electroca←rdiography, laboratory testing, and overnight screening for s≤leep-disordered breathing using the SOMNOcheck micro(®) device were performed.
Results: Contrary to conventional echocardiographic parameters, speckle tracking echocardiography revealσed significant impairment in global LV strain among COPD patieγnts compared to control smokers (-13.3%±5.4% vs -17.1%±1.8%, P=0.04). On a regional£ level, the apical septal LV strain was reduced in COPD (P=0.003) and associated w↑ith the degree of COPD severity (P=0.02). With regard to electrocard•iographic findings, COPD patients exhibited a significantly higher mean heart rate tφhan controls (71.4±13.0 beats per minute vs 60.3±7.7 beats per minute, P=0.001€) that additionally increased over Global Initiative for Chro$nic Obstructive Lung Disease stages (P=0.01). Albeit not statistically signi≠ficant, COPD led to elevated N-terminal pro-brain natriuretic αpeptide levels (453.2±909.0 pg/mL vs 96.8±70.0 pg/mL, P=0.08). As to somnologica✘l testing, the portion of COPD patients exhibiting overlapping OSA accounted for 5.9% and d∞id not significantly vary either in comparison to controls (P=0.07) or throughout the COPD ↓Global Initiative for Chronic Obstructive Lung Disease stage€s (P=0.49). COPD-OSA overlap solely correlated wit∏h nocturnal hypoxemic events, whereas LV performance status was unrelate±d to coexisting OSA.
Conclusion: To conclude, COPD itself seems to be accompanied with ★decreased LV deformation properties that worsen over COPD severity stages, but do not va&ry in case of overlapping OSA.
Keywords: chronic obstructive pulmonary disease; left ventricular dysfunction; overlap syndrome; speckle σtracking echocardiography.
Figures
（以下(xià)為(wèi)翻譯內(nèi)容，可(kě)能(néng)會(huì)有(yǒu)出入，以上(shàng)原文(wén)為(wèi)準！文(wén)章(zhāng)摘自(zì&)https://pubmed.ncbi.nlm.nih.gov/27182264/）
慢(màn)性阻塞性肺疾病和(hé)重疊阻塞性睡(shuì)眠呼吸暫停的(de)斑點追蹤超聲心動圖
卡門(mén)·皮薩羅 1, 法比安·範·埃森(sēn) 1, 法比安·林(lín)霍夫 1, 羅伯特·舒勒 1, 克裡(lǐ)斯托夫·哈默斯廷爾 1, 喬治·尼克尼格 1, 德克·斯科(kē)瓦施 1, 馬塞爾·韋伯 1隸屬關系 擴張
- PMID： 27536094
- PMCID： PMC4976816
- DOI： 10.2147/COPD.S108742
免費(fèi) PMC 文(wén)章(zhāng)
抽象的(de)
背景： COPD 和(hé)充血性心力衰竭代表具有(yǒu)共同病因特征的(de)全球負擔不(bù)斷增加的(de)兩種疾病實體(tǐ)。因此，我們旨在确定 COPD 左心室 (LV) 功能(n≤éng)障礙的(de)程度作(zuò)為(wèi) COPD 嚴重程度階段的(de)函數(shù)，同時(shí)特别強調重疊阻塞性睡(shuì)眠呼吸暫停 (OSA) •的(de)存在。
方法： 共有(yǒu) 85 名 COPD 門(mén)診患者（64.1±10.4 歲，54.1% 男(nán)性☆）和(hé) 20 名對(duì)照(zhào)，年(nián)齡、性别和(hé)吸煙(yān)習(xí)慣®相(xiàng)匹配，接受散斑跟蹤超聲心動圖進行(xíng)左室縱向應變成像。使用(yòng) SOMNOcheck micro(®) 設備對(duì)睡(shuì)眠呼吸障礙進行(xíng)了(le)補充性 12 導聯心電(diàn)圖檢查、實驗室測試和(hé)夜間(jiān)篩查。
結果： 與傳統的(de)超聲心動圖參數(shù)相(xiàng)反，斑點跟蹤超聲心動圖顯示，與對(duì)照(zhào)組吸煙(yān)者相(xiàng)比，COPD 患者的(de)整體(tǐ) LV ↑應變顯著(zhe)受損（-13.3%±5.4% 對(duì) -17.1%±1.8%，P=0.04）。在區(qū)域水(shuǐ)平上(shàng)，COPD 患者<的(de)心尖室間(jiān)隔 LV 應變降低(dī)（P=0.003）并與 COPD 嚴重程度相(xiàng)關（P=0.02）λ。關于心電(diàn)圖結果，COPD 患者的(de)平均心率顯著(zhe)高(gāo)于對(duì)照(zhào)組（∏每分(fēn)鐘(zhōng) 71.4±13.0 次對(duì)每分(fēn)鐘(zhōng) 60.3±7.7 次，P=0.001），并且比全球慢(m♠àn)性阻塞性肺疾病倡議(yì)分(fēn)期還(hái)增加（P =0.01）。盡管沒有(yǒu)統計(jì)學意÷義，COPD 導緻 N 端腦(nǎo)鈉肽前體(tǐ)水(shuǐ)平升高(gāo)（453.2±909.0 pg/mL vs 96.8±70.0 ✔pg/mL，P=0.08）。至于睡(shuì)眠測試，表現(xiàn)出重疊 OSA 的(de) COPD 患者的(de)比例占 5.9%，與對(du<ì)照(zhào)組 (P=0.07) 或整個(gè) COPD 慢(màn)性阻塞性肺疾病全球倡議(yì)" (P=0.49) 相(xiàng)比，沒有(yǒu)顯著(zhe)差異。COPD-OSA 重疊僅與夜間(jiān)低(dī)氧血症事(shì)件(jiàn)相(xiàng)關，而 LV 體(tǐ≈)能(néng)狀态與共存 OSA 無關。
結論： 總而言之，COPD 本身(shēn)似乎伴随著(zhe) LV 變形特性的(de)降低(dī)，這(z'hè)種特性在 COPD 嚴重程度階段會(huì)惡化(huà)，但(dàn)在重疊 OSA 的(de)情況下(xià)不(bù)會(h₽uì)發生(shēng)變化(huà)。
關鍵詞： 慢(màn)性阻塞性肺疾病；左心室功能(néng)障礙; 重疊綜合征; 斑點追蹤超聲心動圖。
數(shù)據
