Campos Jerónimo, Ernst Glenda, Blanco Magali, Cassano Alejandra, Tello-Santa-Cruz Iván, Cáceres-Monié Cesar, Muyran Alexys, Cansonieri Romina, Salvado Alejandro, Borsini Eduardo
Hospital Británico, Department of Respiratory Medicine - Capital - Buenos Aires - Argentina.
Hospital Británico, Argentine Group for Research into Sleep Apnea (GAIAS, for its Spanish acronym) - Capital - Buenos Aires - Argentina.
Sleep Sci. 2018 Jan-Feb;11(1):49-53. doi: 10.5935/1984-0063.20180011.
Obstructive Sleep Apnea (OSA) has been associated with an elevated risk of cardiac arrhythmia. Continuous positive airway pressure (CPAP) is the selected treatment for moderate to severe OSA and could improve arrhythmias in the long term. However, the acute effect of CPAP has not been studied in detail.
We conducted a prospective study with 25 patients with moderate to severe OSA diagnosed by home respiratory polygraphy (RP) and arrhythmia and/or pauses in 24-hour Holter ECG. We analyzed inflammatory parameters and the rate of arrhythmias/pauses after 7 days of auto-adjusting CPAP.
92.5% of the patients were men with a mean age of 61.7±1.9 years. Body mass index (BMI) was 59.5±2.2 kg/m2, with a mean apnea hypopnea index (AHI) of 37.7±3.8 events/hour (ev/h), and a residual AHI (AHIr) of 5.3±0.53 ev/h. After short treatment with CPAP we observed a tendency to improvement in both the severity and number of ventricular extrasystoles (VE) (1595.0±850.3 vs. 926.4±434.5 respectively), pauses and the inflammatory parameters (CRP 3.9±3.1 vs. 1.7±1.2, glycemia 131.4±11.6 vs. 121.9±9.8, HOMA 24.4±3.1 vs. 21.7±2.8, insulin 7.6±1.4 vs. 7.2±1.2 (p>0.5).
We didn't find significant changes in pauses, VE and inflammatory parameters with CPAP short therapy in CPAP naive patients recently diagnosed with OSA.
阻塞性睡眠呼吸暂停（OSA）与心律失常风险升高有关。持续气道正压通气（CPAP）是中重度OSA的首选治疗方法，长期使用可改善心律失常。然而，CPAP的急性效应尚未得到详细研究。
我们对25例经家庭呼吸多导睡眠监测（RP）诊断为中重度OSA且24小时动态心电图监测存在心律失常和/或停搏的患者进行了一项前瞻性研究。我们分析了自动调压CPAP治疗7天后的炎症参数以及心律失常/停搏发生率。
92.5%的患者为男性，平均年龄61.7±1.9岁。体重指数（BMI）为59.5±2.2kg/m²，平均呼吸暂停低通气指数（AHI）为37.7±3.8次/小时（次/小时），残余AHI（AHIr）为5.3±0.53次/小时。短期CPAP治疗后，我们观察到室性早搏（VE）的严重程度和数量（分别为1595.0±850.3和926.4±434.5）、停搏以及炎症参数（CRP 3.9±3.1 vs. 1.7±1.2，血糖131.4±11.6 vs. 121.9±9.8，HOMA 24.4±3.1 vs. 21.7±2.8，胰岛素7.6±1.4 vs. 7.2±1.2（p>0.5））均有改善趋势。
在近期诊断为OSA的初治CPAP患者中，短期CPAP治疗未发现停搏、VE和炎症参数有显著变化。
