Kiciński Paweł, Schlegel Todd, Dybała Andrzej, Zakrzewski Maciej, Przybylska-Kuć Sylwia, Myśliński Wojciech, Mosiewicz Jerzy, Głuszek Stanisław, Jaroszyński Andrzej
Department of Family Medicine, Medical University of Lublin, Lublin, Poland.
Department of Clinical Physiology, Karolinska Institutet, Stockholm, Sweden; Nicollier-Schlegel SARL, Trélex, Switzerland.
Adv Med Sci. 2017 Sep;62(2):240-245. doi: 10.1016/j.advms.2016.11.008. Epub 2017 May 11.
The aim of the study was to assess the spatial QRS-T angle (QRS-TA) in a group of newly diagnosed and untreated adult patients with obstructive sleep apnea syndrome (OSAS) and to identify potential factors affecting this parameter.
The study group (PSG-confirmed OSAS) included 62 individuals, aged 51.7±10.3 years. The control group consisted of 25 individuals, aged 46.6±16.6 years with no sleep-disordered breathing. The diagnosis of OSAS and assessment of its severity was based on unattended all-night screening polysomnography. The spatial QRS-TA was reconstructed from 12-lead ECG using Kors' regression method.
Significant differences of spatial QRS-TA values were found between patients with severe OSAS (36.9±18.9°) and the controls (20.3±13.4°; p<0.01) and between patients with mild or moderate OSAS (32.3±20.1°) and the controls (p=0.01). Statistically significant correlations were found between spatial QRS-TA and polysomnographic indices (i.e. AHI, AI, RDT and RDTI).
Spatial QRS-TA values are significantly higher in patients with OSAS than in controls, thus indicating increased heterogeneity of myocardial action potential. Further long-term prospective studies evaluating the prognostic value of spatial QRS-TA in OSAS patients are needed.
本研究旨在评估一组新诊断且未经治疗的成年阻塞性睡眠呼吸暂停综合征（OSAS）患者的空间QRS-T角（QRS-TA），并确定影响该参数的潜在因素。
研究组（经多导睡眠图证实为OSAS）包括62名个体，年龄为51.7±10.3岁。对照组由25名个体组成，年龄为46.6±16.6岁，无睡眠呼吸紊乱。OSAS的诊断及其严重程度评估基于无人值守的整夜筛查多导睡眠图。使用Kors回归方法从12导联心电图重建空间QRS-TA。
重度OSAS患者（36.9±18.9°）与对照组（20.3±13.4°；p<0.01）之间以及轻度或中度OSAS患者（32.3±20.1°）与对照组之间的空间QRS-TA值存在显著差异。空间QRS-TA与多导睡眠图指标（即AHI、AI、RDT和RDTI）之间存在统计学显著相关性。
OSAS患者的空间QRS-TA值显著高于对照组，从而表明心肌动作电位的异质性增加。需要进一步进行长期前瞻性研究，以评估空间QRS-TA在OSAS患者中的预后价值。
