伴有和不伴有睡眠呼吸暂停的肺动脉高压患者的心率变异性
Heart rate variability in pulmonary hypertension with and without sleep apnea.
作者信息
Carvalho Carolina Gonzaga, Bresler Richard, Zhi Ying Xuan, Alshaer Hisham, Granton John T, Ryan Clodagh M
机构信息
Sleep Research Laboratory, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.
Sleep Laboratory, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil.
出版信息
Heliyon. 2019 Jul 3;5(7):e02034. doi: 10.1016/j.heliyon.2019.e02034. eCollection 2019 Jul.
OBJECTIVES
Our aims were to evaluate HRV in pulmonary hypertension (WHO Group 1 and 4) compared to control subjects, and to assess whether the presence of sleep apnea in those with pulmonary hypertension would be deleterious and cause greater impairment in HRV.
METHODS
This retrospective case-control study analyzed electrocardiogram segments obtained from diagnostic polysomnography.
RESULTS
Forty-one pulmonary hypertension patients were compared to 41 age, sex and apnea-hypopnea index matched healthy controls. The pulmonary hypertension group had decreased high frequency, very low frequency, low frequency, and percentage of normal R-R intervals that differ by > 50 ms compared to control subjects. Moderate to severe right ventricle dysfunction on echocardiography was a predictor of lower high frequency in pulmonary hypertension patients.
CONCLUSIONS
There were no differences in any HRV measures in pulmonary hypertension patients with or without sleep apnea. Impaired HRV was demonstrated in pulmonary hypertension patients however, the presence of sleep apnea did not appear to further reduce vagal modulation.
目的
我们的目的是评估与对照组相比，肺动脉高压（世界卫生组织第1组和第4组）患者的心率变异性（HRV），并评估肺动脉高压患者中睡眠呼吸暂停的存在是否有害以及是否会导致HRV更大程度的损害。
方法
这项回顾性病例对照研究分析了从诊断性多导睡眠图获得的心电图片段。
结果
将41例肺动脉高压患者与41例年龄、性别和呼吸暂停低通气指数相匹配的健康对照者进行比较。与对照组相比，肺动脉高压组的高频、极低频、低频以及正常R-R间期相差>50 ms的百分比均降低。超声心动图显示的中度至重度右心室功能障碍是肺动脉高压患者高频降低的一个预测因素。
结论
有或无睡眠呼吸暂停的肺动脉高压患者在任何HRV指标上均无差异。然而，肺动脉高压患者存在HRV受损，睡眠呼吸暂停的存在似乎并未进一步降低迷走神经调制。
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