阻塞性睡眠呼吸暂停综合征中心脏性猝死病理生理学的线索
Clues to the Pathophysiology of Sudden Cardiac Death in Obstructive Sleep Apnea.
作者信息
Brodovskaya Tatyana Olegovna, Grishina Irina Fedorovna, Peretolchina Tatiana Fedorovna, Solenskaia Olga Georgievna, Kovtun Olga Petrovna, Teplyakova Olga Vyacheslavovna, Chernjadev Sergey Aleksandrovich, Popov Artem Anatolievich, Kurmin Viacheslav Valentinovich
出版信息
Cardiology. 2018;140(4):247-253. doi: 10.1159/000490308. Epub 2018 Sep 11.
BACKGROUND
Risk assessment of sudden cardiac death (SCD) is multifactorial and complex, especially among individuals without established cardiovascular disease. There are insufficiently investigated conditions that can affect arrhythmogenesis. One such condition is obstructive sleep apnea (OSA) syndrome, which is not on the list of risk factors of the Russian National Society of Arrhythmology.
OBJECTIVE
The aim of this review article is to discuss clues to the pathophysiology of SCD in OSA subjects.
METHODS
We searched the literature for data reporting the impact of apnea on arrhythmogenesis. The preferred languages were English and Russian. The most important clinical reports, as well as biochemistry and pathophysiology guides, were selected for inclusion in the review.
RESULTS
It was clearly observed in the searched literature that OSA is the crucial aspect of arrhythmogenesis. Among the clues are intermittent nocturnal hypoxia, reactive oxygen species, cardiomyocyte metabolism disturbances, myocardial electric heterogeneity, and intrathoracic pressure changes.
CONCLUSION
This review emphasizes the importance of the inclusion of OSA in the list of risk factors of the Russian National Society of Arrhythmology.
背景
心脏性猝死（SCD）的风险评估是多因素且复杂的，尤其是在没有确诊心血管疾病的个体中。有一些影响心律失常发生的情况尚未得到充分研究。阻塞性睡眠呼吸暂停（OSA）综合征就是其中之一，它不在俄罗斯心律失常学会的危险因素列表中。
目的
这篇综述文章的目的是探讨OSA患者SCD病理生理学的线索。
方法
我们在文献中搜索有关呼吸暂停对心律失常发生影响的数据报告。首选语言为英语和俄语。选择了最重要的临床报告以及生物化学和病理生理学指南纳入综述。
结果
在所搜索的文献中清楚地观察到，OSA是心律失常发生的关键因素。其中的线索包括间歇性夜间缺氧、活性氧、心肌细胞代谢紊乱、心肌电不均一性和胸内压变化。
结论
本综述强调将OSA纳入俄罗斯心律失常学会危险因素列表的重要性。
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