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持续气道正压通气对心力衰竭合并睡眠呼吸暂停患者室性早搏及心室壁应力的影响

The Effects of Continuous Positive Airway Pressure on Premature Ventricular Contractions and Ventricular Wall Stress in Patients with Heart Failure and Sleep Apnea.

作者信息

Seyis Sabri, Usalan Adnan Kazım, Rencuzogullari Ibrahim, Kurmuş Özge, Gungen Adil Can

机构信息

Department of Cardiology, Live Istinye University Hospital, Istanbul, Turkey.

Department of Chest Disease, Medical Park Hospital, Mersin, Turkey.

出版信息

Can Respir J. 2018 Feb 7;2018:2027061. doi: 10.1155/2018/2027061. eCollection 2018.

Abstract

BACKGROUND

We aimed to investigate the effects of continuous positive airway pressure (CPAP) treatment on electrocardiography (ECG), premature ventricular contraction load on 24-hour Holter recordings, and implantable cardioverter defibrillator (ICD) shocks in patients with obstructive sleep apnea syndrome (OSAS) and heart failure.

METHODS

Patients with heart failure and ICD and patients with newly diagnosed OSAS were divided into two groups according to CPAP treatment. To compare the impact of CPAP on ECG parameters, both baseline and 6-month ECG, 24-hour Holter ECG, ambulatory blood pressure monitoring, echocardiography, polysomnography, and laboratory parameters were collected.

RESULTS

CPAP treatment significantly reduced the frequency of premature ventricular contractions, T-peak to T-end, corrected QT, corrected QT dispersion, and T-peak to T-end/corrected QT ratio in the study group ( < 0.001 for all). Although the baseline NT-pro-BNP levels were similar between study and control groups, after six months, the NT-pro-BNP levels of the study group were significantly lower than that of the control group (39.18 ± 7.57 versus 46.11 ± 7.65;  < 0.001).

CONCLUSIONS

CPAP treatment in patients with heart failure and ICD and in patients with newly diagnosed OSAS may have beneficial effects on premature ventricular contractions and electrocardiographic arrhythmia indices and NT-pro-BNP levels. However, these results are needed to be clarified with further studies.

摘要

背景

我们旨在研究持续气道正压通气(CPAP)治疗对阻塞性睡眠呼吸暂停综合征(OSAS)合并心力衰竭患者的心电图(ECG)、24小时动态心电图记录的室性早搏负荷以及植入式心脏复律除颤器(ICD)电击的影响。

方法

将合并心力衰竭和ICD的患者以及新诊断为OSAS的患者根据CPAP治疗分为两组。为比较CPAP对心电图参数的影响,收集了基线和6个月时的心电图、24小时动态心电图、动态血压监测、超声心动图、多导睡眠图及实验室参数。

结果

在研究组中,CPAP治疗显著降低了室性早搏的频率、T波峰至T波末间期、校正QT间期、校正QT离散度以及T波峰至T波末间期/校正QT比值(所有P均<0.001)。尽管研究组和对照组的基线NT-pro-BNP水平相似,但6个月后,研究组的NT-pro-BNP水平显著低于对照组(39.18±7.57对46.11±7.65;P<0.001)。

结论

CPAP治疗对合并心力衰竭和ICD的患者以及新诊断为OSAS的患者的室性早搏、心电图心律失常指标和NT-pro-BNP水平可能具有有益影响。然而,这些结果需要进一步研究加以阐明。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06da/5829433/914d40b5d2fc/CRJ2018-2027061.001.jpg

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