Department of Medicine, University of Virginia, Charlottesville, VA, USA.
Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA.
Sleep Med. 2018 Aug;48:172-179. doi: 10.1016/j.sleep.2018.05.005. Epub 2018 May 21.
Electrocardiography R-wave to radial artery pulse delay (RRD) represents pulse transit time inclusive of pre-ejection period (PEP) and arterial pulse propagation time. RRD is proposed to largely reflect arterial stiffness when PEP is accounted for (shorter RRD = higher arterial stiffness). Sleep disordered breathing (SDB) causes intermittent hypoxemia and sympathetic activation, which negatively influences vascular function. We aimed to examine the association of measures of SDB with RRD.
Our sample consisted of participants in the Multi-Ethnic Study of Atherosclerosis without prevalent cardiovascular disease who underwent a daytime arterial elasticity exam, cardiac magnetic resonance imaging (MRI), and overnight polysomnography. SDB measures of interest included apnea hypopnea index (AHI) and oxygen desaturation index (ODI) (N = 1173). RRD was regressed on each measure of SDB separately, with adjustment for other cardiovascular risk factors as well as for correlates of the PEP, another component of RRD, by including cardiac MRI measures of contractility and preload.
In multivariate analysis, among measures of SDB, ODI, a marker of intermittent hypoxemia, was inversely associated with RRD (β = -60.2 msec per SD [15.5/hr], p = 0.04). No significant association was found with AHI. In gender stratified analyses, ODI and AHI were predictive of RRD in men only (β = -111.3 msec per SD [15.5/hr], p = 0.01 and β = -100.3 msec per SD [16.1/hr], p = 0.02 respectively).
Severity of SDB as measured by ODI was associated with RRD, a marker of arterial stiffness. Thus, association of RRD with measures of SDB appears to be gender-dependent.
心电图 R 波至桡动脉脉搏延迟（RRD）代表脉搏传播时间，包括射血前期（PEP）和动脉脉搏传播时间。当考虑到 PEP 时，RRD 被认为主要反映动脉僵硬（较短的 RRD=较高的动脉僵硬）。睡眠呼吸紊乱（SDB）导致间歇性低氧血症和交感神经激活，这对血管功能产生负面影响。我们旨在研究 SDB 指标与 RRD 的相关性。
我们的样本包括没有心血管疾病的动脉粥样硬化多民族研究中的参与者，他们接受了日间动脉弹性检查、心脏磁共振成像（MRI）和整夜多导睡眠图检查。感兴趣的 SDB 指标包括呼吸暂停低通气指数（AHI）和氧减指数（ODI）（N=1173）。RRD 分别与每个 SDB 指标进行回归，同时调整其他心血管危险因素以及 RRD 的另一个组成部分，即射血前期的相关性，包括心脏 MRI 测量的收缩力和前负荷。
在多变量分析中，在 SDB 指标中，间歇性低氧血症的标志物 ODI 与 RRD 呈负相关（β=-60.2 毫秒/标准差[15.5/小时]，p=0.04）。与 AHI 无显著相关性。在性别分层分析中，ODI 和 AHI 仅在男性中预测 RRD（β=-111.3 毫秒/标准差[15.5/小时]，p=0.01 和β=-100.3 毫秒/标准差[16.1/小时]，p=0.02）。
ODI 测量的 SDB 严重程度与 RRD 相关，RRD 是动脉僵硬的标志物。因此，RRD 与 SDB 指标的相关性似乎取决于性别。
