title: A Novel Method for Sensitive Determination of Subclinical Left-Ventricular Systolic Dysfunction in Subjects With Obstructive Sleep Apnea.
abstract: BACKGROUND
  This study was to evaluate the subclinical left-ventricular (LV) systolic dysfunction with 2-dimensional speckle-tracking echocardiography in subjects with obstructive sleep apnea (OSA) with normal left ventricular ejection fraction and without any confounding disease that can cause myocardial dysfunction.
  
  
  METHODS
  Nineteen healthy individuals and 60 subjects with OSA were included in this study. According to the severity of disease, OSA subjects were examined in 3 groups: mild, moderate, and severe OSA. LV apical views (for longitudinal strain) and short-axis views (for circumferential strain) were acquired for evaluation. Three-layer longitudinal strain values and circumferential strain values were determined for each view, and averages of these were used in comparison with other groups.
  
  
  RESULTS
  Three-layer longitudinal strain values of the subjects with OSA were lower than those of the healthy individuals, and these values were decreased along with the OSA severity. The difference was significant between severe OSA and all other groups. Three-layer circumferential strain values of the OSA subjects were lower than those of the healthy individuals, and the difference was significant between the control group and all other groups. The apnea hypopnea index was found to be correlated with the 3-layer longitudinal strain (r = -0.74, P < .001; r = -0.72, P < .001; r = -0.69, P = <.001).
  
  
  CONCLUSIONS
  Three-layer longitudinal and circumferential LV systolic functions in OSA subjects with normal left ventricular ejection fraction are deteriorated in the subclinical stage. Two-dimensional speckle-tracking echocardiography can be used as an effective method in the determination of subclinical myocardial dysfunction in subjects with OSA.
authors.affiliation: Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: Nian-Wei
authors.initials: NW
authors.lastname: Zhou
authors.affiliation: Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: Xian-Hong
authors.initials: XH
authors.lastname: Shu
authors.affiliation: Department of Clinical Laboratory, Pudong Hospital, Fudan University, Shanghai, China.
authors.forename: Yi-Li
authors.initials: YL
authors.lastname: Liu
authors.affiliation: Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Shen
authors.affiliation: Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Wen-Jing
authors.initials: WJ
authors.lastname: Li
authors.affiliation: Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: Xue
authors.initials: X
authors.lastname: Gong
authors.affiliation: Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: Hai-Yan
authors.initials: HY
authors.lastname: Chen
authors.affiliation: Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: Wei-Peng
authors.initials: WP
authors.lastname: Zhao
authors.affiliation: Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, Shanghai, China. pan.cuizhen@zs-hospital.sh.cn li.shanqun@zs-hospital.sh.cn.
authors.forename: Cui-Zhen
authors.initials: CZ
authors.lastname: Pan
authors.affiliation: Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, China. pan.cuizhen@zs-hospital.sh.cn li.shanqun@zs-hospital.sh.cn.
authors.forename: Shan-Qun
authors.initials: SQ
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000503:physiopathology; D013318:Stroke Volume; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology; D016277:Ventricular Function, Left
keywords: myocardial strain; obstructive sleep apnea; speckle-tracking echocardiography