ABSTRACT
Objective:To investigate the correlations between serum E selectin, intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1) and left ventricular geometry and function in patients with obstructive sleep apnea syndrome (OSAS) combined with prehypertension (pre-HT).Methods:A total of 462 patients with pre-HT and OSAS diagnosed by polysomnography (PSG) in the sleep monitoring unit of the Department of Respiratory and Critical Care Medicine at the First Hospital of Shanxi Medical University from July 2019 to July 2022 were restrospectively analysed, and 52 patients with pure pre-HT (pre-HT group) and 73 patients with pure OSAS (OSAS group) in the same period were selected as the control group. OSAS and pre-HT patients were divided into four groups according to left ventricular geometry: normal geometry (NG) group, concentric remodeling (CR) group, eccentric hypertrophy (EH) group and concentric hypertrophy (CH) group. The general clinical data, PSG parameters, blood biochemical parameters and left ventricular structure and function parameters were compared among the six groups. Pearson correlation and multivariate Logistic regression were used to analyze the correlation between E-selection, ICAM-1, VCAM-1, general clinical data, PSG parameters, blood biochemical parameters with left ventricular geometry and function.Results:①Serum E selectin, ICAM-1, and VCAM-1 concentrations increased sequentially from the NG, CR, and EH to CH groups, with the most significant increase in CH group (all P<0.05). In addition, there were statistically significant differences in age, body mass index (BMI), OSAS severity, neck circumference, waist circumference, systolic blood pressure (SBP), diastolic blood pressure (DBP), Glu, lowest oxygen saturation (Lowest-SaO 2), mean oxygen saturation (Mean-SaO 2), percentage of time with oxygen saturation below 90% of total sleep time (T90), left ventricular end-diastolic diameter (LVEDd), interventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT), left ventricular mass index (LVMI), relative ventricular wall thickness (RWT), left ventricular ejection fraction (LVEF), peak mitral early diastolic flow velocity/peak mitral late diastolic flow velocity (E/A), E wave deceleration time (DT), A wave duration (AD), and isovolumic relaxation time (IVRT), and overall long-axis longitudinal strain (GLS) and so on(all P<0.05). ②Pearson correlation analysis showed that E selectin was negatively correlated with LVEF, E/A, e′, E/e′, IVRT, and GLS ( r=-0.236, -0.131, -0.224, -0.215, -0.285, -0.336; all P<0.05). ICAM-1 was negatively correlated with LVEF, E, E/A, e′, IVRT, and GLS( r=-0.130, -0.129, -0.104, -0.351, -0.252, -0.259; all P<0.05). VCAM-1 was negatively correlated with E, e′, and IVRT ( r=-0.132, -0.312, -0.387; all P<0.001). ③Multifactorial logistic regression analysis showed that E selectin and VCAM-1 were independently correlated with EH (β=1.139, OR=3.124, P=0.030; β=1.288, OR=3.626, P<0.001) and with CH (β=1.178, OR=3.248, P=0.013; β=1.108, OR=3.028, P<0.001). Conclusions:E selection and VCAM-1 were independently correlated with hypertrophic left ventricular geometry, suggesting that E selectin and VCAM-1 may be involved in the process of abnormal left ventricular structure and function in patients with OSAS combined with pre-HT.
ABSTRACT
Objective:To investigate the correlation between serum cystatin C (Cys C) and left ventricular geometry in patients with obstructive sleep apnea syndrome (OSAS) complicated with prehypertension(PH).Methods:A total of 408 patients with PH and OSAS diagnosed by polysonogram monitoring in the sleep monitoring room of Respiratory Department, the First Hospital of Shanxi Medical University from July 2018 to June 2021 were collected. Serum Cys C concentration and echocardiography were performed in all patients. According to the classification of left ventricular geometry, all patients were divided into four groups: normal configuration (NG) group( n=297), concentric remodeling (CR) group( n=49), eccentric hypertrophy (EH) group( n=33), and concentric hypertrophy (CH) group( n=29). General clinical data, sleep parameters, blood biochemical parameters, Cys C concentration and echocardiographic parameters were compared among the four groups, and the correlation between serum Cys C and left ventricular geometry was analyzed. Results:①The serum Cys C concentration increased successively from NG group, CR group, EH group to CH group, and the increase in CH group was the most obvious ( P<0.05). In addition, there were statistically significant differences in body mass index (BMI), waist circumference, systolic blood pressure (SBP), diastolic blood pressure (DBP), severity of OSAS, the percentage of the time that the blood oxygen saturation was less than 90% of the total sleep time (T90), lowest oxygen saturation (Lowest-SaO 2), mean oxygen saturation (Mean-SaO 2), left ventricular end diastolic diameter (LVEDD), inter-ventricular septal diameter (IVST), left ventricular posterior wall thickness diameter (LVPWT), left ventricular mass index (LVMI), relative wall thickness (RWT), left ventricular ejection fraction (LVEF) and E/A among all groups (all P<0.05). ②Multivariate Logistic regression analysis showed that Cys C was independently correlated with CR (β=0.721, OR=2.057, P=0.047), EH(β=0.961, OR=2.614, P=0.017) and CH (β=1.180, OR=3.254, P=0.010). Conclusions:There is a correlation between serum Cys C and left ventricular geometry in OSAS patients with PH, suggesting that serum Cys C might be involved in the change of left ventricular geometry.