Table 1_Effect of obstructive sleep apnea–hypopnea syndrome on myocardial mechanics in obese patients.docx

ObjectiveObesity and obstructive sleep apnea-hypopnea syndrome (OSAHS) often coexist. Chronic intermittent hypoxia in OSAHS can compound cardiac remodeling, but the comprehensive impact of OSAHS severity on obese patients remains unclear.
MethodsA total of 83 obese patients were included in this study and divided into the obesity-only group (27 cases) and the obesity-OSAHS group (56 cases) based on the presence of OSAHS. An additional 30 healthy individuals served as the control group. According to the apnea-hypopnea index (AHI), the obesity-OSAHS group was further classified into a mild group (30 cases), moderate group (16 cases), and severe group (10 cases). Echocardiographic and strain parameters were compared across these groups, and factors influencing global longitudinal strain (GLS) were analyzed.
ResultsLeft ventricular GLS progressively declined across the control group (−21.28%), obesity-only group (−18.85%), and obesity-OSAHS group (−17.03%) (all P<0.05). Within the OSAHS group, GLS decreased with increasing severity: mild (−18.00%), moderate (−16.69%), and severe (−14.69%) (all P < 0.05). Structural cardiac remodeling was more pronounced in the severe group, with a left ventricular mass index (LVMI) value of 101.64 g/m2, compared with 87.11 g/m2 in the moderate group and 83.94 g/m2 in the mild group (P = 0.016). The AHI and LVMI were identified as independent predictors of reduced GLS.
ConclusionObese patients exhibit impaired myocardial mechanics, which is further aggravated by OSAHS. With increasing OSAHS severity, GLS declines and myocardial dysfunction worsens. AHI and LVMI are independent risk factors for this dysfunction in obese patients with OSAHS.