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The AutoStrain LV technique is a sensitive method for detecting subclinical left ventricular dysfunction in patients
1Department of Medical Ultrasound, First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Abstract:
Obstructive sleep apnea syndrome (OSAS) is strongly associated with multiple cardiovascular diseases, however, early detection of subclinical myocardial damage is a challenge. We aimed to compare the sensitivity of AutoStrain LV technology versus conventional echocardiography for assessing left ventricular (LV) impairment in patients with subclinical OSAS and to identify sensitive echocardiographic indicators of LV injury. Classifying 126 qualified participants based on their apnea-hypopnea index (AHI), we formed control, mild, moderate, and severe OSAS categories. LV global longitudinal strain (LVGLS) was evaluated by AutoStrain LV technique. Conventional two-dimensional echocardiography was used to measure different factors including LV end-diastolic diameter, LV end-systolic diameter, interventricular septum diameter, LV posterior wall diameter, and LV functional shortening. LV ejection fraction was calculated by modified biplane Simpson method, and the Doppler ultrasound was used to measure the LV diastolic function indices E/A and E/E'. We calculated the correlations between these ultrasound parameters and the AHI. Although LV ejection fraction and LV functional shortening are normal, the LVGLS in the OSAS group decreased with the severity of the disease (P < .001). The values of E/A in the mild, moderate, and severe OSAS groups, as well as the values of E/E' in the mild and severe OSAS groups, showed significant differences compared to the control group, but no significant differences were found between different OSAS subgroups. The IVST and LVPWT values in the moderate and severe OSAS groups were higher than those in the control group and mild OSAS group, but there were no significant differences between the other groups. Conventional echocardiographic parameters did not change with the severity of the disease. Correlation analysis showed that LVGLS had the strongest correlation with AHI (r = -0.732, P < .001). Compared with conventional echocardiography, AutoStrain LV technology has a higher sensitivity for monitoring LV function impairment in patients with subclinical OSAS.
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