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阻塞性睡眠呼吸暂停综合征患者的心率加速期和减速期

Heart rate acceleration runs and deceleration runs in patients with obstructive sleep apnea syndrome.

作者信息

Jiang Jie, Chen Xue, Zhang Cheng, Wang Guangfa, Fang Jing, Ma Jing, Zhang Jue

机构信息

Department of Cardiology, Peking University First Hospital, Beijing, 100034, China.

Advanced Academy of Interdisciplinary Studies, Peking University, Beijing, 100871, China.

出版信息

Sleep Breath. 2017 May;21(2):443-451. doi: 10.1007/s11325-016-1437-6. Epub 2016 Nov 23.

Abstract

PURPOSE

This study aimed to explore the patterns of heart rate acceleration runs and deceleration runs in patients with obstructive sleep apnea syndrome and to investigate the influence of apnea events on this pattern.

METHODS

The 6-h electrocardiography results of patients who were referred for overnight polysomnography were retrospectively analyzed. The frequencies of heart rate acceleration runs and deceleration runs of different lengths were calculated for each patient and compared among patients with obstructive sleep apnea syndrome of varying degrees of severity, between patients with obstructive sleep apnea on and off continuous positive airway pressure, and between two matched groups of patients with idiopathic central sleep apnea and obstructive sleep apnea.

RESULTS

A total of 231 patients were enrolled. Patients with severe obstructive sleep apnea exhibited significantly increased frequencies of long acceleration and deceleration runs after multivariate adjustment, while no significant differences were observed in the frequencies of short runs. Thirty-nine obstructive sleep apnea patients who were treated with continuous positive airway pressure showed a significant decrease in the frequency of long deceleration runs and a decreasing trend in the frequency of long acceleration runs. Patients with idiopathic pure central sleep apnea exhibited no significant changes in the frequencies of acceleration and deceleration runs after they were placed on continuous positive airway pressure.

CONCLUSIONS

The distributions of heart rate acceleration and deceleration runs are related to the severity of obstructive sleep apnea. Long runs are more closely related to obstructive respiratory events, while short runs do not appear to be related to these events.

摘要

目的

本研究旨在探讨阻塞性睡眠呼吸暂停综合征患者心率加速和减速的模式,并研究呼吸暂停事件对该模式的影响。

方法

回顾性分析因夜间多导睡眠图检查而转诊患者的6小时心电图结果。计算每位患者不同长度的心率加速和减速的频率,并在不同严重程度的阻塞性睡眠呼吸暂停综合征患者之间、持续气道正压通气开启和关闭时的阻塞性睡眠呼吸暂停患者之间,以及两组匹配的特发性中枢性睡眠呼吸暂停和阻塞性睡眠呼吸暂停患者之间进行比较。

结果

共纳入231例患者。多因素调整后,重度阻塞性睡眠呼吸暂停患者的长加速和减速频率显著增加,而短频率无显著差异。39例接受持续气道正压通气治疗的阻塞性睡眠呼吸暂停患者,长减速频率显著降低,长加速频率呈下降趋势。特发性单纯中枢性睡眠呼吸暂停患者接受持续气道正压通气后,加速和减速频率无显著变化。

结论

心率加速和减速的分布与阻塞性睡眠呼吸暂停的严重程度有关。长频率与阻塞性呼吸事件关系更密切,而短频率似乎与这些事件无关。

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