Department of Pulmonology, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Nuclear Medicine, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
Clin Respir J. 2022 Sep;16(9):611-617. doi: 10.1111/crj.13532. Epub 2022 Aug 8.
Airflow limitation in patients with obstructive sleep apnea (OSA) leads to arousal, increased sympathetic nervous system activity, and elevated blood pressure, which causes a decrease in pulse transit time (PTT). The present study aims to evaluate the effect of CPAP therapy on PTT in patients with moderate to severe OSA. This was a cross-sectional study. Split-night polysomnography (PSG) study was performed for each participant with apnea-hypopnea index (AHI) ≥ 15 before and during CPAP therapy. The PTT was calculated as the time interval between the R wave of the electrocardiogram and the following arrival point in fingertip photoplethysmography. PTT drop was defined as a fall in the PTT curve of ≥15 ms lasting at least for 3 s and at most for 30 s. PTT drop index was defined as the number of drops in PTT that occur per hour of sleep. A total of 30 patients were included. PTT significantly increased, and PTT drop index significantly decreased during CPAP therapy (P < 0.001). PTT was significantly correlated to sleep efficiency (r = -0.376, P = 0.049) and oxygen desaturation index (ODI) (r = -0.428, P = 0.018). PTT drop index was strongly correlated to AHI (r = 0.802, P < 0.001), respiratory disturbance index (RDI) (r = 0.807, P < 0.001), ODI (r = 0.693, P < 0.001), arousal index (r = 0.807, P < 0.001), and periodic leg movement (PLM) index (r = 0.400, P = 0.035). Overall, the findings from this study indicated that the PTT drop index is a non-invasive and useful marker for evaluating the severity of OSA and the effectiveness of treatment in patients with moderate to severe OSA.
阻塞性睡眠呼吸暂停（OSA）患者的气流受限导致觉醒、交感神经系统活动增加和血压升高，从而导致脉搏传输时间（PTT）缩短。本研究旨在评估 CPAP 治疗对中重度 OSA 患者 PTT 的影响。这是一项横断面研究。对每位参与者进行了分段式多导睡眠图（PSG）研究，在开始 CPAP 治疗前和治疗期间，参与者的呼吸暂停低通气指数（AHI）≥15。PTT 是通过计算心电图 R 波和指尖光容积脉搏波的下一个到达点之间的时间间隔得出的。PTT 下降定义为 PTT 曲线下降≥15ms 且持续至少 3s 但不超过 30s。PTT 下降指数定义为每小时睡眠中 PTT 下降的次数。共纳入 30 例患者。CPAP 治疗期间，PTT 显著升高，PTT 下降指数显著降低（P<0.001）。PTT 与睡眠效率显著相关（r=-0.376，P=0.049），与氧减指数（ODI）显著相关（r=-0.428，P=0.018）。PTT 下降指数与 AHI（r=0.802，P<0.001）、呼吸紊乱指数（RDI）（r=0.807，P<0.001）、ODI（r=0.693，P<0.001）、觉醒指数（r=0.807，P<0.001）和周期性肢体运动（PLM）指数（r=0.400，P=0.035）均有很强的相关性。总的来说，本研究结果表明，PTT 下降指数是一种非侵入性的有用标志物，可用于评估中重度 OSA 患者的严重程度和治疗效果。
