Varga Paula Cornelia, Rosianu Horia Stefan, Vesa Ştefan Cristian, Hancu Bianca Gergely Domokos, Beyer Ruxandra, Pop Carmen Monica
Department of Cardiology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, România.
Department of Cardiology, Heart Institute "Niculae Stancioiu," Cluj-Napoca, Romania.
J Res Med Sci. 2020 Apr 13;25:42. doi: 10.4103/jrms.JRMS_677_18. eCollection 2020.
Obstructive sleep apnea (OSA) can lead to cardiac complications: brady and tachyarrhythmias and sudden cardiac death. Continuous positive airway pressure (CPAP) is the gold standard for the treatment of OSA. The present study aims to demonstrate the efficiency of CPAP in the treatment of cardiac arrhythmias in patients with OSA. The study also recorded the frequency of arrhythmias in patients with untreated OSA and assessed the association between the severity of OSA and the occurrence of arrhythmias.
This is a prospective cohort study. Ninety-three patients with OSA were included, aged 60 (58-64) years, with female/male sex ratio of 1:4. They were subjected simultaneously to home respiratory polygraphy examination and Holter electrocardiogram monitoring, in two different stages: at diagnosis and at the 3-month checkup after CPAP treatment. The presence of supraventricular and ventricular arrythmias was noted. Respiratory parameter values were also recorded.
Statistically significant decrease in the occurrence of supraventricular ( < 0.001) and ventricular extrasystoles ( < 0.001), atrial fibrillation (AF) ( = 0.03), nonsustained ventricular tachycardia (NSVT) ( = 0.03), and sinus pauses ( < 0.001) was observed 3 months after treatment with CPAP, compared with baseline. The apnea-hypopnea index (AHI) was correlated with the ventricular extrasystoles ( = 0.273; = 0.008). The ejection fraction of the left ventricle was inversely correlated with the episodes of NSVT ( = -0.425; < 0.001). AF was associated with the longest apnea ( = 0.215; = 0.04). Cardiac activity pauses were correlated with AHI ( = 0.320; = 0.002), longest apnea ( = 0.345; = 0.01), and oxygen desaturation index ( = 0.325; = 0.04).
The prevalence of cardiac arrhythmias in patients with OSA was reduced after 3 months of CPAP therapy. Cardiac arrhythmias were correlated with the severity of OSA.
阻塞性睡眠呼吸暂停（OSA）可导致心脏并发症：心动过缓和快速性心律失常以及心源性猝死。持续气道正压通气（CPAP）是治疗OSA的金标准。本研究旨在证明CPAP治疗OSA患者心律失常的有效性。该研究还记录了未经治疗的OSA患者的心律失常频率，并评估了OSA严重程度与心律失常发生之间的关联。
这是一项前瞻性队列研究。纳入93例OSA患者，年龄60（58 - 64）岁，女性/男性性别比为1:4。他们在两个不同阶段同时接受家庭呼吸多导睡眠图检查和动态心电图监测：诊断时以及CPAP治疗后3个月的复查时。记录室上性和室性心律失常的存在情况。还记录了呼吸参数值。
与基线相比，CPAP治疗3个月后，室上性早搏（<0.001）、室性早搏（<0.001）、心房颤动（AF）（=0.03）、非持续性室性心动过速（NSVT）（=0.03）和窦性停搏（<0.001）的发生率在统计学上有显著下降。呼吸暂停低通气指数（AHI）与室性早搏相关（=0.273；=0.008）。左心室射血分数与NSVT发作呈负相关（=-0.425；<0.001）。AF与最长呼吸暂停相关（=0.215；=0.04）。心脏活动暂停与AHI（=0.320；=0.002）、最长呼吸暂停（=0.345；=0.01）和氧饱和度下降指数（=0.325；=0.04）相关。
CPAP治疗3个月后，OSA患者心律失常的患病率降低。心律失常与OSA的严重程度相关。
