الفهرس 
I IntroductionOnly 14 pages are availabe for public view
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Abstract
Obstructive sleep apnea (OSA) is a sleep disorder that involves cessation or significant decrease in airflow in the presence of breathing effort. It’s the most common type of sleep disordered breathing and is characterized by recurrent episodes of upper airway collapse during sleep, these episodes are associated with recurrent oxyhemoglobin desaturation and frequent arousal from sleep. Patient with obstructive sleep apnea have an increased prevalence of systemic and pulmonary hypertension, left ventricular hypertrophy ,left ventricular systolic and diastolic dysfunction and congestive heart failure, increased platelet agregability, and increased susceptibility to thrombotic and embolic cardiac and cerebrovascular strokes. patient with obstructive sleep apnea have increased prevalence of coronary artery disease, myocardial infarction, angina, arrhythmia, ischemia, sudden cardiac death. In our study we evaluated the effect of obstructive sleep apnea syndrome on the structural and functional parameters of the left ventricle and to detect the reversibility of possible changes after uvulopalatpharyngoplastye. preoperative evaluation was done by polysomnography for assessment of severity of obstructive sleep apnea. CT neck , nose and paranasal sinuses , flexible nasopharyngoscopy for detection of obstruction site. Echocardiography , Doppler mitral flow and tissue doppler image for assessment of cardiac function preoperative and 6 months postoperative. In the current study twenty patients with moderate to severe AHI were evaluated 6 month after uvulopalatopharyngoplasty for their cardiac function and as regard the structural parameters there was left
ventricular hypertrophy (increased IVSD ,LVPWD) which was reversible 6 months after surgical treatment ,and regarding the systolic function there was improvement in EF ,FS , GLs (global longitudinal strain ) 6 months after surgery. In addition, regarding the diastolic function, there was improvement in E/A ratio , IVRT. The results of our study were in agreement with other recent studies regarding the results of echocardiography as end systolic diameter, ejection fraction , interventricular septum ,left ventricle posterior wall diameter also with the results of Doppler mitral flow regarding E wave ,A wave ,E/A ratio. Moreover , the results of tissue Doppler regarding isovolumic relaxation time , global longitudinal strain ,S`m ,E`m , A`m velocity mtched the results of previous studies. However there was some disagreement with previous studies regarding fractional shortening , end diastolic diameter ,E/A ratio.This disagreement may be attributed to different sample size of the studied group , other disease affecting cardiac function , instruments used , and the operator . In the current study, there was a highly significant correlation between BMI and A/H index reflecting severity of OSA. Also ,there was a highly significant correlation between A/H index and some cardiac parameters including LVM ,IVRT ,E/A ratio. This correlation was in agreement with previos studies. The current study leads to the conclusion that obstructive sleep apnea has structural and functional left ventricular changes which is reversible 6 months after effective surgical management by Uvulopalatopharyngoplasty in palatal obstruction. The severity of obstructive sleep apnea is highly correlated with the magnitude of left
ventricular changes which reveals the need for eary management of obstructive sleep apnea.