Cilli A, Tatlicioğlu T, Köktürk O
Department of Chest Diseases, Gazi University School of Medicine, Ankara, Turkey.
Jpn Heart J. 1999 Jan;40(1):23-9. doi: 10.1536/jhj.40.23.
Nocturnal oxygen desaturation and sleep apnea may provoke myocardial ischemia and arrhythmias in patients with coronary artery disease (CAD). Additionally, these factors may accelerate coronary atherosclerosis in the long term and they may play a role in the progression of the disease process. On the other hand, studies related to this subject are limited. This study was conducted to investigate the nocturnal oxygen desaturation and apneas during sleep in patients with CAD and to assess the possible association of these factors with CAD. We studied 22 male patients with CAD confirmed by coronary angiography who did not have symptomatic pulmonary disease and fourteen male healthy controls without known heart disease. Patients were randomly selected from men undergoing coronary angiography. Controls were age and sex matched and selected from the population registry. The normal controls were of similar body mass index to the patients. None of them were obese. The patients and controls underwent standard polysomnography. Men with CAD and controls had a similar apnea-hypopnea index (2.3 +/- 3.8 vs. 1.2 +/- 1.7). Mean oxygen desaturation index was higher among patients than controls (2.1 vs. 0.5, p < 0.05). Patients with CAD spent 3.1% (9.7 +/- 13.6) of total sleep time desaturated, while the same proportion in controls were 0.5% (1.9 +/- 4.1)(p < 0.05). Although both groups of patients were of similar heart rates at initial, the development of bradycardia during sleep was significantly higher in patients compared with controls (43.3% vs. 25.3%, p < 0.05). The results demonstrate that sleep disordered breathing, in particular nocturnal oxygen desaturation, occurs more common in patients with CAD compared to controls. Additionally, patients are at higher risk of developing bradycardia during sleep. This findings suggest that oxygen desaturation during sleep might contribute to the progression of CAD.
夜间氧饱和度降低和睡眠呼吸暂停可能会诱发冠心病（CAD）患者的心肌缺血和心律失常。此外，从长远来看，这些因素可能会加速冠状动脉粥样硬化，并且可能在疾病进程的发展中起作用。另一方面，与此主题相关的研究有限。本研究旨在调查CAD患者睡眠期间的夜间氧饱和度降低和呼吸暂停情况，并评估这些因素与CAD之间可能存在的关联。我们研究了22例经冠状动脉造影确诊患有CAD且无症状性肺部疾病的男性患者，以及14例无已知心脏病的男性健康对照者。患者是从接受冠状动脉造影的男性中随机选取的。对照者在年龄和性别上相匹配，并从人口登记处选取。正常对照者的体重指数与患者相似。他们中没有人肥胖。患者和对照者均接受了标准的多导睡眠图检查。CAD男性患者和对照者的呼吸暂停低通气指数相似（2.3±3.8对1.2±1.7）。患者的平均氧饱和度降低指数高于对照者（2.1对0.5，p<0.05）。CAD患者总睡眠时间中有3.1%（9.7±13.6）处于氧饱和度降低状态，而对照者的这一比例为0.5%（1.9±4.1）（p<0.05）。尽管两组患者最初的心率相似，但与对照者相比，患者睡眠期间心动过缓的发生率显著更高（43.3%对25.3%，p<0.05）。结果表明，与对照者相比，睡眠呼吸障碍，尤其是夜间氧饱和度降低，在CAD患者中更为常见。此外，患者在睡眠期间发生心动过缓的风险更高。这些发现表明，睡眠期间的氧饱和度降低可能会促进CAD的进展。
