Deng Ming, Huang Yi-Teng, Xu Jian-Qing, Ke Xiao, Dong Yi-Fei, Cheng Xiao-Shu
Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, China.
Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
Front Physiol. 2021 Feb 12;11:608347. doi: 10.3389/fphys.2020.608347. eCollection 2020.
The present study was undertaken to examine the association between intermittent hypoxia and left ventricular (LV) remodeling and explore which parameter of intermittent hypoxia is most relevant to LV remodeling in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Two hundred eighty six patients underwent polysomnographic examination were enrolled. Based on apnea-hypoxia index (AHI), patients were divided into no, mild, moderate and severe OSAHS groups. Between-group differences in LV remodeling and the association between parameters of intermittent hypoxia and LV remodeling was evaluated. Patients with severe OSAHS were more likely to have hypertension, and higher values of LV mass (LVM) and LVM index (LVMI). In univariate regression analysis, male, body mass index (BMI), systolic and diastolic blood pressure (BP), statins, antihypertensive drugs, creatinine, and parameters of intermittent hypoxia (AHI, obstructive apnea index [OAI], lowest oxygen saturation [LSpO], oxygen desaturation index [ODI], time spent below oxygen saturation of 90% [TS90%], and mean nocturnal oxygen saturation [MSpO]) were associated with LVMI. After multivariate regression analyses, only male gender, BMI, systolic BP, creatinine, and ODI remained significantly associated with LVMI. Compared to those without LV hypertrophy (LVH), patients with LVH had higher ODI. Compared to patients with normal LV, concentric remodeling and eccentric LVH, those with concentric LVH had higher ODI. In conclusion, intermittent hypoxia was significantly associated with left ventricular remodeling; and among various parameters of intermittent hypoxia, ODI was the most relevant to LV remodeling.
本研究旨在探讨间歇性低氧与左心室(LV)重构之间的关联,并探究在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者中,间歇性低氧的哪个参数与LV重构最为相关。纳入了286例接受多导睡眠图检查的患者。根据呼吸暂停低氧指数(AHI),将患者分为无、轻度、中度和重度OSAHS组。评估了各组之间LV重构的差异以及间歇性低氧参数与LV重构之间的关联。重度OSAHS患者更易患高血压,且左心室质量(LVM)和左心室质量指数(LVMI)值更高。在单因素回归分析中,男性、体重指数(BMI)、收缩压和舒张压(BP)、他汀类药物、抗高血压药物、肌酐以及间歇性低氧参数(AHI、阻塞性呼吸暂停指数[OAI]、最低氧饱和度[LSpO]、氧去饱和指数[ODI]、低于90%氧饱和度的时间[TS90%]以及夜间平均氧饱和度[MSpO])与LVMI相关。经过多因素回归分析后,只有男性性别、BMI、收缩压、肌酐和ODI仍与LVMI显著相关。与无左心室肥厚(LVH)的患者相比,LVH患者的ODI更高。与左心室正常、向心性重构和离心性LVH的患者相比,向心性LVH患者的ODI更高。总之,间歇性低氧与左心室重构显著相关;在间歇性低氧的各种参数中,ODI与LV重构最为相关。