Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan.
J Cardiol. 2012 Jul;60(1):61-5. doi: 10.1016/j.jjcc.2012.01.012. Epub 2012 Mar 7.
Recently, the role of sleep-disordered breathing (SDB) in cardiovascular disease has attracted attention. In this study, we investigated the influence of SDB on postoperative arrhythmias after cardiac surgery.
In 89 patients undergoing cardiac surgery, postoperative portable monitoring for SDB and Holter electrocardiography were performed. The primary end-points were the apnea-hypopnea index (AHI) and occurrence of arrhythmia. The secondary end-points were: (1) patient background factors; (2) average heart rate; (3) maximum heart rate (total, daytime, and nighttime); (4) minimum heart rate (total, daytime, and nighttime); (5) minimum SaO(2) during sleep; and (6) an independent predictor for arrhythmia. Twenty-six patients (29.2%) had an AHI≥15 and they were classified into the SDB group, while patients with an AHI<15 formed the non-SDB group (70.8%). Although there was no significant difference in atrial fibrillation, frequent nocturnal premature ventricular contractions were significantly more common in the SDB group (19.2%) than the non-SDB group (3.2%) (p=0.01). Maximum daytime and nighttime heart rates were also significantly higher in the SDB group. AHI was a significant predictor for frequent nocturnal premature ventricular contractions.
This study showed that SDB is common among patients undergoing cardiac surgery, and that SDB might be closely associated with arrhythmia in these patients.
最近，睡眠呼吸障碍（SDB）在心血管疾病中的作用引起了关注。在这项研究中，我们调查了 SDB 对心脏手术后心律失常的影响。
在 89 例行心脏手术的患者中，进行了术后便携式 SDB 监测和动态心电图监测。主要终点是呼吸暂停-低通气指数（AHI）和心律失常的发生。次要终点是：（1）患者背景因素；（2）平均心率；（3）最大心率（总、白天和夜间）；（4）最小心率（总、白天和夜间）；（5）睡眠期间最低 SaO2；（6）心律失常的独立预测因素。26 例（29.2%）患者 AHI≥15，被分为 SDB 组，而 AHI<15 的患者为非 SDB 组（70.8%）。尽管心房颤动无显著差异，但 SDB 组频发夜间室性早搏（19.2%）明显多于非 SDB 组（3.2%）（p=0.01）。SDB 组日间和夜间最大心率也明显升高。AHI 是频发夜间室性早搏的显著预测因素。
本研究表明，心脏手术后患者 SDB 很常见，SDB 可能与这些患者的心律失常密切相关。
