睡眠呼吸暂停对急性心力衰竭患者 24 小时及夜间心电图和血压参数的影响。

The Influence of Sleep Apnea on 24-Hour and Nocturnal ECG and Blood Pressure Parameters in Patients with Acute Heart Failure.

机构信息

Department of Internal Medicine IV, University of Medicine and Pharmacy of Tirgu Mures, Tirgu Mures, Romania,

Department of Cardiology, Clinical County Hospital Mures, Tirgu Mures, Romania.

出版信息

Med Princ Pract. 2019;28(2):150-157. doi: 10.1159/000496148. Epub 2018 Dec 11.

DOI:10.1159/000496148

PMID:30537750

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6545910/

Abstract

OBJECTIVE

To investigate the influence of sleep apnea (SA) on ECG and blood pressure (BP) monitoring parameters in patients with acute heart failure (AHF).

METHODS

A total of 51 hospitalized patients with AHF (13 women, 38 men, mean age 60.8 years) underwent 24-hour combined monitoring of ECG and BP and SA testing before discharge. Heart rhythm (mean heart rate, arrhythmias, pauses, QT interval, heart rate variability) and BP (mean systolic and diastolic values, variability, circadian variation) parameters were obtained for the whole day and for nighttime (22: 00-06: 00). Depending on SA severity, the patients were divided into two groups (respiratory event index, REI, < 15/h and ≥15/h). Comparisons of parameters between the two groups were performed using t test and χ2 test (alpha < 0.05 for significance).

RESULTS

A total of 29 (56.9%) patients had REI ≥15/h. In this group, the systolic and diastolic BP values (24-hour and nighttime) were significantly higher (p < 0.05). BP variability did not differ, and a markedly blunted circadian variation of both the systolic and diastolic values was observed. In the group with REI ≥15/h, we found a higher nocturnal versus diurnal mean heart rate ratio (p = 0.046) and a greater occurrence of nocturnal versus diurnal ventricular premature beats (p = 0.0098).

CONCLUSION

The presence of significant SA was found to influence the BP values and nocturnal ventricular ectopy in patients with stabilized AHF. SA, 24-hour ECG, and BP monitoring could provide important information with potential impact on patient management.

摘要

目的

探讨睡眠呼吸暂停（SA）对急性心力衰竭（AHF）患者心电图（ECG）和血压（BP）监测参数的影响。

方法

共纳入 51 例住院 AHF 患者（女性 13 例，男性 38 例，平均年龄 60.8 岁），在出院前进行 24 小时 ECG 和 BP 联合监测及 SA 检测。获得全天和夜间（22:00-06:00）的心率（平均心率、心律失常、停搏、QT 间期、心率变异性）和 BP（平均收缩压和舒张压值、变异性、昼夜变化）参数。根据 SA 严重程度，将患者分为两组（呼吸事件指数，REI，<15/h 和≥15/h）。使用 t 检验和 χ2 检验比较两组之间的参数（alpha < 0.05 为显著性差异）。

结果

共有 29 例（56.9%）患者的 REI≥15/h。在该组中，24 小时和夜间的收缩压和舒张压值明显升高（p<0.05）。BP 变异性无差异，但收缩压和舒张压的昼夜变化明显减弱。在 REI≥15/h 的组中，我们发现夜间与日间平均心率比值较高（p=0.046），夜间与日间室性早搏发生次数较多（p=0.0098）。