Baumert Mathias, Smith Janet, Catcheside Peter, McEvoy R Douglas, Abbott Derek, Sanders Prashanthan, Nalivaiko Eugene
School of Electrical & Electronic Engineering, Centre for Biomedical Engineering, University of Adelaide, Adelaide, Australia.
Sleep. 2008 Jul;31(7):959-66.
To determine OSA-related changes in variability of QT interval duration and in heart rate variability (HRV), and to evaluate the relationship of these parameters to disease severity.
Retrospective analysis of diagnostic sleep records.
Clinical sleep laboratory in a hospital setting.
Twenty patients (12 males and 8 females) without significant comorbidities who were undergoing polysomnography were studied.
Standard heart rate variability measures and QT variability (Berger algorithm) were computed over consecutive 5-minute ECG epochs throughout the night. The effect of sleep stage and the relationship between these parameters and the severity of OSA as determined by the respiratory disturbance index (RDI) were explored. Further, a linear regression model of QT variability was developed. Severity of OSA (RDI) was 49 +/- 28 (range from 17-107) events/ hr. QT variability was the only ECG measure significantly correlated with RDI (both log-transformed; r = 0.6, P = 0.006). Further, QT variability was correlated with the minimum oxygen saturation (r = -0.55, P = 0.01). Sleep stage showed a significant effect on HRV, but not on QT variability. In the regression model, RDI was the strongest predictor of QT variability (R2 increase 38%), followed by high and low frequency power of HRV (R2 increase 10% each).
Obstructive sleep apnea is associated with changes in QT interval variability during sleep. The variance of beat-to-beat QT intervals correlates more strongly with the severity of OSA (as determined by RDI) than standard measures of heart rate variability, and is correlated with blood oxygenation, but not sleep stage.
确定阻塞性睡眠呼吸暂停（OSA）相关的QT间期持续时间变异性和心率变异性（HRV）的变化，并评估这些参数与疾病严重程度的关系。
对诊断性睡眠记录进行回顾性分析。
医院环境中的临床睡眠实验室。
对20例无明显合并症且正在接受多导睡眠监测的患者（12例男性和8例女性）进行研究。
在整个夜间连续的5分钟心电图时段内计算标准心率变异性指标和QT变异性（伯杰算法）。探讨睡眠阶段的影响以及这些参数与通过呼吸紊乱指数（RDI）确定的OSA严重程度之间的关系。此外，建立了QT变异性的线性回归模型。OSA的严重程度（RDI）为49±28（范围为17 - 107）次/小时。QT变异性是唯一与RDI显著相关的心电图指标（两者均经对数转换；r = 0.6，P = 0.006）。此外，QT变异性与最低氧饱和度相关（r = -0.55，P = 0.01）。睡眠阶段对HRV有显著影响，但对QT变异性无影响。在回归模型中，RDI是QT变异性的最强预测因子（R²增加38%），其次是HRV的高频和低频功率（R²各增加10 %）。
阻塞性睡眠呼吸暂停与睡眠期间QT间期变异性的变化有关。逐搏QT间期的方差与OSA的严重程度（由RDI确定）的相关性比心率变异性的标准指标更强，并且与血氧合相关，但与睡眠阶段无关。
