Faculty of Medicine, Department of Cardiology, Bezmialem Foundation University, Istanbul, Turkey.
Faculty of Medicine, Department of Pulmonary Medicine, Bezmialem Foundation University, Istanbul, Turkey.
Ann Noninvasive Electrocardiol. 2021 Mar;26(2):e12809. doi: 10.1111/anec.12809. Epub 2020 Oct 16.
Obstructive sleep apnea (OSA) is a highly prevalent sleep disorder associated with important cardiovascular complications including ventricular arrhythmias. Tp-Te interval, Tp-Te/QT, and Tp-Te/QTc ratios are repolarization indices representing ventricular arrhythmogenic potential. These parameters are associated with ventricular arrhythmias and sudden cardiac death. The aim of this study was to investigate the correlation between apnea-hypopnea index and Tp-Te, Tp-Te/QT, and Tp-Te/QTc in OSA.
We screened a total of 280 patients who underwent overnight polysomnography (PSG) between the years 2012-2017 at our institution. Patients were assigned into four groups based on severity of apnea-hypopnea index: 70 with apnea-hypopnea index (AHI) <5 (control group), 71 with 5 ≤ AHI < 15, 63 with 15 ≤ AHI < 30, and 76 with AHI ≥ 30. Tp-Te, Tp-Te/QT, and Tp-Te/QTc were measured.
Compared to control group, repolarization parameters were significantly prolonged in other groups (Tp-Te interval: 68.3 ± 6.8, 71.8 ± 6.3, 79.1 ± 5.5, and 85.1 ± 6.4 ms, p < .001; Tp-Te/QT ratio: 167.5 ± 12.7, 181.7 ± 13.0, 202.2 ± 10.0 and 219.4 ± 13.5, p < .001; Tp-Te/QTc ratio: 151.1 ± 16.6, 167.6 ± 16.6, 193.7 ± 14.4, and 225.5 ± 17.0, p < .001). There was a significant trend toward higher Tp-Te, Tp-Te/QT, and Tp-Te/QTc across higher AHI categories. In a univariate regression analysis, body mass index, smoking status, Tp-Te, and Tp-Te/QTc were significantly associated with the severity of AHI in OSA. Tp-Te (OR 1.629, 95% CI 1.393-1.906, p < .001), Tp-Te/QTc (OR 1,333 95% CI 1.247-1.424, p < .001), and smoking status (OR 5.771, 95% CI 1.025-32.479, p = .047) were found to be significant independent predictors of severity of AHI in a multivariate analysis, after adjusting for other risk parameters.
Our study showed that Tp-Te, Tp-Te/QT, and Tp-Te/QTc were prolonged in patients with OSA. There was significant correlation between apnea-hypopnea index and these parameters.
阻塞性睡眠呼吸暂停（OSA）是一种与重要心血管并发症相关的高度流行的睡眠障碍，包括室性心律失常。Tp-Te 间期、Tp-Te/QT 和 Tp-Te/QTc 比值是代表室性心律失常发生倾向的复极指数。这些参数与室性心律失常和心脏性猝死有关。本研究旨在探讨 OSA 患者中呼吸暂停-低通气指数与 Tp-Te、Tp-Te/QT 和 Tp-Te/QTc 之间的相关性。
我们筛选了 2012 年至 2017 年间在我院接受过夜多导睡眠图（PSG）检查的 280 例患者。根据呼吸暂停-低通气指数的严重程度将患者分为四组：呼吸暂停-低通气指数（AHI）<5 的 70 例（对照组），5≤AHI<15 的 71 例，15≤AHI<30 的 63 例，AHI≥30 的 76 例。测量 Tp-Te、Tp-Te/QT 和 Tp-Te/QTc。
与对照组相比，其他组的复极参数明显延长（Tp-Te 间期：68.3±6.8、71.8±6.3、79.1±5.5 和 85.1±6.4ms，p<0.001；Tp-Te/QT 比值：167.5±12.7、181.7±13.0、202.2±10.0 和 219.4±13.5，p<0.001；Tp-Te/QTc 比值：151.1±16.6、167.6±16.6、193.7±14.4 和 225.5±17.0，p<0.001）。随着 AHI 类别的升高，Tp-Te、Tp-Te/QT 和 Tp-Te/QTc 呈显著升高趋势。在单因素回归分析中，体重指数、吸烟状况、Tp-Te 和 Tp-Te/QTc 与 OSA 患者 AHI 的严重程度显著相关。Tp-Te（OR 1.629，95%CI 1.393-1.906，p<0.001）、Tp-Te/QTc（OR 1.333 95%CI 1.247-1.424，p<0.001）和吸烟状况（OR 5.771，95%CI 1.025-32.479，p=0.047）在调整其他风险参数后，在多因素分析中被发现是 AHI 严重程度的显著独立预测因素。
我们的研究表明，OSA 患者的 Tp-Te、Tp-Te/QT 和 Tp-Te/QTc 延长。呼吸暂停-低通气指数与这些参数之间存在显著相关性。
