emcardioНеотложная кардиология и кардиоваскулярные рискиEmergency Cardiology and Cardiovascular Risks journal2616-633XБелорусский государственный медицинский университет10.51922/2616-633X.2021.5.2.1184emcardio-152Research ArticleОригинальные научные публикацииOriginal Scientific ResearchСтруктурно-функциональные особенности левых отделов сердца у лиц трудоспособного возраста с синдромом обструктивного апноэ во снеStructural and functional left heart changes in the working age individuals with obstructive seep apnea syndrome (OSAS)ЮшкевичЕ. К.YushkevichE. K.ПетроваЕ. Б.PetrovaE. B.МитьковскаяН. П.MitkovskayaN. P.Белорусский государственный медицинский университетBelarusian State Medical UniversityУЗ «Городская клиническая больница скорой медицинской помощи»Minsk City Emergency HospitalГУ «Республиканский научно-практический центр «Кардиология»“Cardiology” Republican Scientific and Practical Centre2021221020255111841189Copyright © Юшкевич Е.К., Петрова Е.Б., Митьковская Н.П., 20252025Юшкевич Е.К., Петрова Е.Б., Митьковская Н.П.Yushkevich E.K., Petrova E.B., Mitkovskaya N.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://emcardio.bsmu.by/jour/article/view/152

Синдром обструктивного апноэ во сне (СОАС) является общепризнанным фактором риска ряда кардиоваскулярных событий и исходов. Одним из аспектов неблагоприятного прогноза у лиц с СОАС выступают структурно-функциональные изменения левых отделов сердца, степень которых коррелирует с тяжестью обструктивных нарушений во время сна. Характерные для СОАС ведущие компоненты метаболического синдрома (абдоминальное ожирение, сахарный диабет тип 2, артериальная гипертензия) ассоциируются с развитием сходных изменений геометрии сердца, что затрудняет оценку непосредственной роли обструктивного апноэ в процессах ремоделирования.

The aim of the study. To assess the echocardiographic signs of structural and left heart functional changes in the working age individuals with obstructive sleep apnea syndrome.

синдром обструктивного апноэ во снеинтермиттирующая гипоксияиндекс апноэ/гипопноээхокардиографиядиастолическая функция левого желудочкаремоделирование левых отделов сердцаobstructive sleep apnea syndromeintermittent hypoxiaapnea/hypopnea indexechocardiographyleft ventricular diastolic functionremodeling of the left heartReferencesKryukova A.I. eds. Sindrom obstruktivnogo apnoe` sna: diagnostika i konservativnoe lechenie. Poziciya nevrologa : metod. rekomendacii [Obstructive sleep apnea syndrome: diagnosis and conservative treatment. Neurologist’s position: method. recommendations]. Moskva, 2020. 25 s. (in Russian).Kryukova A.I. eds. Sindrom obstruktivnogo apnoe` sna: diagnostika i konservativnoe lechenie. Poziciya nevrologa : metod. rekomendacii [Obstructive sleep apnea syndrome: diagnosis and conservative treatment. Neurologist’s position: method. recommendations]. Moskva, 2020. 25 s. (in Russian).Marcus C.L., Brooks L.J., Draper K.A., Gozal D. Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics, 2012, vol. 130, no. 3, pp. 714-755.Marcus C.L., Brooks L.J., Draper K.A., Gozal D. Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics, 2012, vol. 130, no. 3, pp. 714-755.Shahar E., Whitney C.W., Redline S., Lee E.T., Newman A.B., Nieto F.J., O’Connor G.T., Boland L.L., Schwartz J.E., Samet J.M. Sleep-disordered breathing and cardiovasculardiseases: cross-sectional results of the Sleep Heart Health Study. Am J Respir Crit Care Med, 2001, vol. 163, no. 1, pp. 19-25. doi: 10.1164/ajrccm.163.1.2001008.Shahar E., Whitney C.W., Redline S., Lee E.T., Newman A.B., Nieto F.J., O’Connor G.T., Boland L.L., Schwartz J.E., Samet J.M. Sleep-disordered breathing and cardiovasculardiseases: cross-sectional results of the Sleep Heart Health Study. Am J Respir Crit Care Med, 2001, vol. 163, no. 1, pp. 19-25. doi: 10.1164/ajrccm.163.1.2001008.Mannarino M.R., Di Filippo F., Pirro M. Obstructive sleep apnea syndrome. Eur J Intern Med, 2012, vol. 23, no. 7, pp. 586-593. doi: 10.1016/j.ejim.2012.05.013.Mannarino M.R., Di Filippo F., Pirro M. Obstructive sleep apnea syndrome. Eur J Intern Med, 2012, vol. 23, no. 7, pp. 586-593. doi: 10.1016/j.ejim.2012.05.013.Trombetta I.C., Somers V.K., Maki-Nunes C., Drager L.F., Toschi-Dias E., Alves M.J., Fraga R.F., Rondon M.U., Bechara M.G., Lorenzi-Filho G., Negrão C.E. Consequences of comorbid sleep apnea in the metabolic syndrome - implications for cardiovascularrisk. Sleep, 2010, vol. 33, no. 9, pp.1193-1199. doi: 10.1055/s-0030-1254404.Trombetta I.C., Somers V.K., Maki-Nunes C., Drager L.F., Toschi-Dias E., Alves M.J., Fraga R.F., Rondon M.U., Bechara M.G., Lorenzi-Filho G., Negrão C.E. Consequences of comorbid sleep apnea in the metabolic syndrome - implications for cardiovascularrisk. Sleep, 2010, vol. 33, no. 9, pp.1193-1199. doi: 10.1055/s-0030-1254404.Cortelli P., Lombardi C. Sleep and autonomic nervous system dysfunction. In: Guilleminault C. ed. Clinical neurophysiology of sleep disorders. Handbook of Clinical Neurophysiology. Elseiver, 2005, pp. 343-353.Cortelli P., Lombardi C. Sleep and autonomic nervous system dysfunction. In: Guilleminault C. ed. Clinical neurophysiology of sleep disorders. Handbook of Clinical Neurophysiology. Elseiver, 2005, pp. 343-353.Dursunoglu N., Dursunoglu D. Obstructive sleep apnea syndrome, endothelial dysfunction and coronary atherosclerosis. Tuberk Toraks, 2005, vol. 53, no. 3, pp. 299-306.Dursunoglu N., Dursunoglu D. Obstructive sleep apnea syndrome, endothelial dysfunction and coronary atherosclerosis. Tuberk Toraks, 2005, vol. 53, no. 3, pp. 299-306.Kraiczi H., Caidahl K., Samuelsson A., Peker Y., Hedner J. Impairment of vascular endothelial function and left ventricular filling: Association with the severity of apnea-induced hypoxemia during sleep. Chest, 2001, vol. 119, no. 4, pp. 1085-1091 doi: 10.1378/chest.119.4.1085.Kraiczi H., Caidahl K., Samuelsson A., Peker Y., Hedner J. Impairment of vascular endothelial function and left ventricular filling: Association with the severity of apnea-induced hypoxemia during sleep. Chest, 2001, vol. 119, no. 4, pp. 1085-1091 doi: 10.1378/chest.119.4.1085.Ryan S., Nolan G.M., Hannigan E., Cunningham S., Taylor C., McNicholas W.T. Cardiovascular risk markers in obstructive sleep apnoea syndrome and correlation with obesity. Thorax, 2007, vol. 62, no. 6, pp. 509-514.Ryan S., Nolan G.M., Hannigan E., Cunningham S., Taylor C., McNicholas W.T. Cardiovascular risk markers in obstructive sleep apnoea syndrome and correlation with obesity. Thorax, 2007, vol. 62, no. 6, pp. 509-514.Yushkevich E.K., Kartun L.V., Mitkovskaya N.P. Funkzionalnoe sostoyanie endoteliya u liz trudosposobnogo vozrasta s sindromom obstruktivnogo apnoe sna [Functional state of endothelium in working age subjects with obstructive sleep apnea syndrome]. Neotlozhnaya kardiologiya i kardiovaskulyarnye riski, 2019, vol. 3, no. 1, pp. 553-558. (in Russian).Yushkevich E.K., Kartun L.V., Mitkovskaya N.P. Funkzionalnoe sostoyanie endoteliya u liz trudosposobnogo vozrasta s sindromom obstruktivnogo apnoe sna [Functional state of endothelium in working age subjects with obstructive sleep apnea syndrome]. Neotlozhnaya kardiologiya i kardiovaskulyarnye riski, 2019, vol. 3, no. 1, pp. 553-558. (in Russian).Gorbunova M.V., Babak S.L., Borovitsky V.S., Naumenko Z.K., Malyavin A.G. Model for prediction of left ventricular myocardial hypertrophy in patients with obstructive sleep apnea. Rus Arch Int Med, 2020, vol. 10, no. 6, pp. 458-467. doi.org/10.20514/2226-6704-2020-10-6-458-467.Gorbunova M.V., Babak S.L., Borovitsky V.S., Naumenko Z.K., Malyavin A.G. Model for prediction of left ventricular myocardial hypertrophy in patients with obstructive sleep apnea. Rus Arch Int Med, 2020, vol. 10, no. 6, pp. 458-467. doi.org/10.20514/2226-6704-2020-10-6-458-467.Aslan K., Deniz A., Cayli M., Bozdemir H., Sarica Y., Seydaoglu G. Early left ventricular functional alterations in patients with obstructive sleep apnea syndrome. Cardiol J, 2013, vol. 20, no. 5, pp. 519-525. doi: 10.5603/CJ.2013.0043.Aslan K., Deniz A., Cayli M., Bozdemir H., Sarica Y., Seydaoglu G. Early left ventricular functional alterations in patients with obstructive sleep apnea syndrome. Cardiol J, 2013, vol. 20, no. 5, pp. 519-525. doi: 10.5603/CJ.2013.0043.Niroumand M., Kuperstein R., Sasson Z., Hanly P.J. Impact of obstructive sleep apnea on left ventricular mass and diastolic function. Am J Respir Crit Care Med, 2001, vol. 163, no. 7, pp. 1632-1636. doi: 10.1164/ajrccm.163.7.2007014.Niroumand M., Kuperstein R., Sasson Z., Hanly P.J. Impact of obstructive sleep apnea on left ventricular mass and diastolic function. Am J Respir Crit Care Med, 2001, vol. 163, no. 7, pp. 1632-1636. doi: 10.1164/ajrccm.163.7.2007014.Chen Y.L., Su M.C., Liu W.H., Wang C.C., Lin M.C., Chen M.C. Influenceand predicting variables of obstructive sleep apnea on cardiac function and remodeling in patients without congestive heart failure. J Clin Sleep Med, 2014, vol. 10, no. 1, pp. 57-64. doi: 10.5664/jcsm.3360.Chen Y.L., Su M.C., Liu W.H., Wang C.C., Lin M.C., Chen M.C. Influenceand predicting variables of obstructive sleep apnea on cardiac function and remodeling in patients without congestive heart failure. J Clin Sleep Med, 2014, vol. 10, no. 1, pp. 57-64. doi: 10.5664/jcsm.3360.Sascău R., Zota I.M., Stătescu C., Boișteanu D., Roca M., Maștaleru A., Leon Constantin M.M., Vasilcu T.F., Gavril R.S., Mitu F. Review of Echocardiographic Findings in Patients with Obstructive Sleep Apnea. Can Respir J, 2018, vol. 18. doi: 10.1155/2018/1206217. eCollection 2018.Sascău R., Zota I.M., Stătescu C., Boișteanu D., Roca M., Maștaleru A., Leon Constantin M.M., Vasilcu T.F., Gavril R.S., Mitu F. Review of Echocardiographic Findings in Patients with Obstructive Sleep Apnea. Can Respir J, 2018, vol. 18. doi: 10.1155/2018/1206217. eCollection 2018.WangJ., ZhangH., WuC., HanJ., GuoZ., JiaC., YangL., HaoY., XuK., LiuX., SiJ. CorrelationofLeft Ventricular Diastolic Function and Left Ventricular Geometry in Patients with Obstructive Sleep ApnoeaSyndrome. West Indian Med J,2015vol. 64, no. 2, pp. 92-98. doi:10.7727/wimj.2014.054.WangJ., ZhangH., WuC., HanJ., GuoZ., JiaC., YangL., HaoY., XuK., LiuX., SiJ. CorrelationofLeft Ventricular Diastolic Function and Left Ventricular Geometry in Patients with Obstructive Sleep ApnoeaSyndrome. West Indian Med J,2015vol. 64, no. 2, pp. 92-98. doi:10.7727/wimj.2014.054.Bodez D., Damy T., Soulat-Dufour L., Meuleman C., Cohen A. Consequences of obstructive sleep apnoea syndrome on left ventricular geometry and diastolic function. Arch Cardiovasc Dis, 2016, vol. 109, no. 8-9, pp. 494-503. doi: 10.1016/j.acvd.2016.02.011.Bodez D., Damy T., Soulat-Dufour L., Meuleman C., Cohen A. Consequences of obstructive sleep apnoea syndrome on left ventricular geometry and diastolic function. Arch Cardiovasc Dis, 2016, vol. 109, no. 8-9, pp. 494-503. doi: 10.1016/j.acvd.2016.02.011.Yu L., Li H., Liu X., Fan J., Zhu Q., Li J., Jiang J., Wang J. Left ventricular remodeling and dysfunction in obstructive sleep apnea : Systematic review and meta-analysis. Herz, 2020, vol. 45, no. 8, pp. 726-738. doi:10.1007/s00059-019-04850-w.Yu L., Li H., Liu X., Fan J., Zhu Q., Li J., Jiang J., Wang J. Left ventricular remodeling and dysfunction in obstructive sleep apnea : Systematic review and meta-analysis. Herz, 2020, vol. 45, no. 8, pp. 726-738. doi:10.1007/s00059-019-04850-w.Iwasaki Y.K., Shi Y., Benito B., Gillis M.A., Mizuno K., Tardif J.-C., Nattel S. Determinants of atrial fibrillationin an animal model of obesity and acute obstructive sleep apnea. Heart Rhythm, 2012, vol. 9, no. 9, pp. 1409-1416.e1401. doi: 10.1016/j.hrthm.2012.03.024.Iwasaki Y.K., Shi Y., Benito B., Gillis M.A., Mizuno K., Tardif J.-C., Nattel S. Determinants of atrial fibrillationin an animal model of obesity and acute obstructive sleep apnea. Heart Rhythm, 2012, vol. 9, no. 9, pp. 1409-1416.e1401. doi: 10.1016/j.hrthm.2012.03.024.Abdullozoda S.M. Nekotorye aspekty epidemiologii i etiopatogeneza metabolicheskogo sindroma [Some aspects of epidemiology and etiopathogenesis of metabolic syndrome]. Vestnik Avizenny, 2020, vol. 22, no. 4, pp. 580-594. (in Russian).Abdullozoda S.M. Nekotorye aspekty epidemiologii i etiopatogeneza metabolicheskogo sindroma [Some aspects of epidemiology and etiopathogenesis of metabolic syndrome]. Vestnik Avizenny, 2020, vol. 22, no. 4, pp. 580-594. (in Russian).Lang R.M., Badano L.P., Mor-Avi V., Afilalo J., Armstrong A., Ernande L., Flachs-kampf F.A., Foster E., Goldstein S.A., Kuznetsova T., Lancellotti P., Muraru D., Picard M.H., Rietzschel E.R., Rudski L., Spencer K.T., Tsang W., Voigt J.U. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging, 2015, vol. 16, no. 3, pp. 233-70. doi: 10.1093/ehjci/jev014.[Erratum in: Eur Heart J Cardiovasc Imaging. 2016 Apr;17(4):412. Erratum in: Eur Heart J Cardiovasc Imaging. 2016 Sep;17 (9):969].Lang R.M., Badano L.P., Mor-Avi V., Afilalo J., Armstrong A., Ernande L., Flachs-kampf F.A., Foster E., Goldstein S.A., Kuznetsova T., Lancellotti P., Muraru D., Picard M.H., Rietzschel E.R., Rudski L., Spencer K.T., Tsang W., Voigt J.U. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging, 2015, vol. 16, no. 3, pp. 233-70. doi: 10.1093/ehjci/jev014.[Erratum in: Eur Heart J Cardiovasc Imaging. 2016 Apr;17(4):412. Erratum in: Eur Heart J Cardiovasc Imaging. 2016 Sep;17 (9):969].Kim S.M., Cho K.I., Kwon J.H., Lee H.G., Kim T.I. Impact of obstructive sleep apnea on left atrial functional and structural remodeling beyond obesity. J Cardiol, 2012, vol. 60, no. 6, pp. 475-483. doi: 10.1016/j.jjcc.2012.07.007.Kim S.M., Cho K.I., Kwon J.H., Lee H.G., Kim T.I. Impact of obstructive sleep apnea on left atrial functional and structural remodeling beyond obesity. J Cardiol, 2012, vol. 60, no. 6, pp. 475-483. doi: 10.1016/j.jjcc.2012.07.007.Jean-Louis G., Zizi F., Brown D., Ogedegbe G., Borer J., McFarlane S. Obstructive sleep apnea and cardiovascular disease: evidence and underlying mechanisms. Minerva Pneumol, 2009, vol. 48, no. 4, pp. 277-293.Jean-Louis G., Zizi F., Brown D., Ogedegbe G., Borer J., McFarlane S. Obstructive sleep apnea and cardiovascular disease: evidence and underlying mechanisms. Minerva Pneumol, 2009, vol. 48, no. 4, pp. 277-293.

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