Lyshova O V, Borodin N V, Kostenko I I
Voronezh State Medical University named after N.N. Burdenko, Voronezh, Russia.
Kardiologiia. 2017 May;57(5):23-29.
To access the detectability of corrected QT interval (QTc) prolongation ( more or equal 450 ms) and increased QT dispersion (QTd more or equal 60 ms) in men with obstructive sleep apnea-hypopnea syndrome (OSAS) and newly diagnosed arterial hypertension (AH).
We included in this study 138 men (mean age 40.5+/-6.9 years, body mass index 34.5+/-4.7 kg/m2, all with more or equal 3 risk factors of AH development, 34% with subclinical target organs damage). According to office systolic and diastolic blood pressure level (SBP and DBP), AH of 1st degree was diagnosed in 103 (74.6%), 2nd - in 26 (18.9%) and 3rd - in 9 (6.5%) patients. All patients underwent 24-h multifunctional monitoring. According to the apnea-hypopnea index (AHI) patients were divided into 4 groups: I (control, n=34) with AHI less than 5/h, II (n=36) with AHI 5-14/h, III (n=32) with AHI 15-29/h, IV (n=36) with AHI more or equal 30/h.
There were no significant intergroup differences in age, body mass index, sleep duration, mean daytime SBP, QT and JT dispersion in the diurnal, daytime and nighttime periods. However, in group IV values of mean heart rate (in normal range), daytime DBP, nighttime SBP and DBP, QTc and JTc intervals were higher than in other groups. Portions of patients with prolonged QTc and increased QTd were 38.2 and 35.3%, 44.4 and 33.3%, 34.4 and 40.6%; 50.0 and 38.9% in groups I, II, III, IV, respectively. Multiple regression analysis revealed associations between mean diurnal QTc interval prolongation and reduction of mean oxygen saturation (SpO2) during sleep, and between mean diurnal JTc interval prolongation and increase of AHI.
Rates of detection of QTc interval prolongation and QTd increase in men with newly diagnosed AH and OSAS of different severity were almost similar. However, there was a trend to higher detectability of QTc interval prolongation (50.0%) among patients with AHI more or equal 30/h. Reduction of mean SpO2 and AHI increase during sleep were found to be predictors of diurnal QTc and JTc intervals prolongation, respectively.
评估阻塞性睡眠呼吸暂停低通气综合征（OSAS）合并新诊断动脉高血压（AH）男性患者校正QT间期（QTc）延长（≥450毫秒）及QT离散度增加（QTd≥60毫秒）的可检测性。
本研究纳入138名男性（平均年龄40.5±6.9岁，体重指数34.5±4.7千克/平方米，均有≥3个AH发生风险因素，34%有亚临床靶器官损害）。根据诊室收缩压和舒张压水平（SBP和DBP），103例（74.6%）患者诊断为1级AH，26例（18.9%）为2级，9例（6.5%）为3级。所有患者均接受24小时多功能监测。根据呼吸暂停低通气指数（AHI），患者分为4组：I组（对照组，n = 34），AHI小于5次/小时；II组（n = 36），AHI为5 - 14次/小时；III组（n = 32），AHI为15 - 29次/小时；IV组（n = 36），AHI≥30次/小时。
在年龄、体重指数、睡眠时间、日间平均SBP、QT及JT离散度的日间、白天和夜间时段，组间无显著差异。然而，IV组的平均心率（在正常范围内）、白天DBP、夜间SBP和DBP、QTc及JTc间期值高于其他组。QTc延长和QTd增加的患者比例在I组、II组、III组、IV组分别为38.2%和35.3%、44.4%和33.3%、34.4%和40.6%、50.0%和38.9%。多元回归分析显示，日间平均QTc间期延长与睡眠期间平均血氧饱和度（SpO2）降低相关，日间平均JTc间期延长与AHI增加相关。
新诊断AH合并不同严重程度OSAS的男性患者中，QTc间期延长和QTd增加的检出率几乎相似。然而，AHI≥30次/小时的患者中，QTc间期延长的可检测性有升高趋势（50.0%）。睡眠期间平均SpO2降低和AHI增加分别被发现是日间QTc和JTc间期延长的预测因素。
Zotero 插件