Effect of Obstructive Sleep Apnea–Hypopnea Syndrome on Myocardial Mechanics in Obese Patients

Demographic parameters (age, sex, height, weight) and cardiovascular-metabolic indices—including heart rate, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, total cholesterol, high-density lipoprotein cholesterol, triglycerides, and low-density lipoprotein cholesterol—were recorded. BMI and body surface area were calculated using the standard formulas. All participants underwent overnight polysomnography monitoring (21:00–07:00), and the AHI was calculated as the average number of apnea or hypopnea events per hour of sleep. Each patient underwent a standard echocardiographic examination. Prior to image acquisition, participants were instructed to rest for 5 minutes and were connected to an electrocardiogram in the left lateral position. M-mode echocardiography was performed from the long-axis view of the left ventricle to measure interventricular septal thickness at end-diastole, left ventricular posterior wall thickness at end-diastole, left ventricular end-diastolic diameter, and left ventricular end-systolic diameter. The left ventricular ejection fraction was calculated using Simpson’s biplane method from apical four- and two-chamber views. Early diastolic mitral peak flow velocity (E) was measured using pulsed Doppler in the apical four-chamber view, and early diastolic mitral annular average velocity (e′) in the septal and lateral walls was obtained via tissue Doppler imaging. Image analysis was performed using the EchoPAC workstation by importing two-dimensional gray-scale dynamic images of each patient, and the software automatically generated the GLS value of the left ventricular myocardium along with a 17-segment bull’s-eye map of longitudinal strain.