Kaviraj Bundhoo, Bai Shu-chang, Su Liang, Zheng Xue-ou, Huang Rong, Li Tao-ping, Xu Ding-li
Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2011 Feb;31(2):197-200.
To assess the changes of serum C-reactive protein (CRP) level, left atrial size and atrial premature contraction (PAC) in patients with obstructive sleep apnea syndrome (OSAS).
This study involved 277 patients with OSAS diagnosed after an overnight polysomnography, who underwent a 24-h Holter electrocardiography and ambulatory blood pressure monitoring for detection of PAC. According to the apnea-hypopnea index (AHI), 137 patients with PAC identified from these patients were classified into 3 groups, namely the mild (5≥AHI<15), moderate (15≥AHI<30) and severe (AHI≥30) groups. Serum CRP level was assessed by a high-sensitivity radio-immunoassay. The left atrial diameter and echocardiographic parameters were recorded by transthoracic Doppler echocardiography (TTE).
We found a high prevalence of PAC in these OSAS patients (137/277, 49.4%). Serum CRP was significantly higher in severe OSAS group (5.01∓4.68 mg/L) than in the moderate (3.03∓1.94 mg/L) and mild OSAS (2.98∓1.82 mg/L) groups (P=0.040 and 0.033, respectively). The left atrial diameter was significantly increased in severe OSAS group (40.1∓7.9 mm) as compared to that in moderate (37.9∓5.5 mm) and mild (33.7 ∓ 3.8 mm) groups (P=0.025 and 0.002, respectively). The severity of OSAS was positively correlated to both CRP (r=0.304, P=0.034) and left atrial diameter (r=0.411, P=0.003). After adjusting for gender, age and body mass index (BMI), a strong correlation was found between the left atrial diameter and CRP (r=0.594, P=0.0005).
There is a high prevalence of PAC in OSAS patients. The progression of OSAS is associated with increased serum CRP level and left atrial size in patients with premature atrial complexes. Our study suggests that inflammation associated with OSAS might contribute to atrial structural and electrical remodeling in OSAS patients with PAC.
评估阻塞性睡眠呼吸暂停综合征（OSAS）患者血清C反应蛋白（CRP）水平、左心房大小及房性早搏（PAC）的变化。
本研究纳入277例经夜间多导睡眠图诊断为OSAS的患者，这些患者接受了24小时动态心电图检查及动态血压监测以检测PAC。根据呼吸暂停低通气指数（AHI），将从这些患者中识别出的137例有PAC的患者分为3组，即轻度（5≥AHI<15）、中度（15≥AHI<30）和重度（AHI≥30）组。采用高敏放射免疫分析法评估血清CRP水平。经胸多普勒超声心动图（TTE）记录左心房直径及超声心动图参数。
我们发现这些OSAS患者中PAC的患病率较高（137/277，49.4%）。重度OSAS组血清CRP水平（5.01±4.68mg/L）显著高于中度（3.03±1.94mg/L）和轻度OSAS组（2.98±1.82mg/L）（P分别为0.040和0.033）。与中度（37.9±5.5mm）和轻度（33.7±3.8mm）组相比，重度OSAS组左心房直径显著增加（40.1±7.9mm）（P分别为0.025和0.002）。OSAS的严重程度与CRP（r=0.304，P=0.034）及左心房直径（r=0.411，P=0.003）均呈正相关。在调整性别﹑年龄和体重指数（BMI）后，发现左心房直径与CRP之间存在强相关性（r=0.594，P=0.0005）。
OSAS患者中PAC的患病率较高。OSAS的进展与房性早搏患者血清CRP水平升高及左心房大小增加有关。我们的研究表明，与OSAS相关的炎症可能导致有PAC的OSAS患者出现心房结构和电重构。
