Wang Y X, Xiao Y
Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2023 Feb 12;46(2):128-136. doi: 10.3760/cma.j.cn112147-20221219-00981.
To further investigate the relationship between sleep apnea and coronary heart disease. Obstructive sleep apnea (OSA) is associated with various cardiovascular diseases including coronary heart disease. Moderate to severe OSA patients are prone to more severe coronary stenosis. We combined the serological indicators, echocardiography and coronary angiography all together to further investigate the relationship between sleep apnea and coronary heart disease. A total of 110 coronary heart disease patients who underwent coronary angiography and overnight polysomnography during hospitalization were enrolled, including 97 males and 13 females aged 27-85 years. Data of baseline characteristics, biochemical measurements, echocardiography, coronary angiography and polysomnography were collected. The differences in cardiovascular indicators of different degrees of OSA were compared by -test and nonparametric test. Logistic regression was used to analyze the risk factors for OSA and coronary stenosis. The median age of the enrolled 110 patients was 56 years. Totally, 88.2% patients were male and 84.5% suffered from OSA. Patients with moderate to severe OSA had a greater degree of heart rate variation during sleep, a wider proximal ascending aorta, and were more prone to abnormal right heart structure, however, no significant difference was found in myocardial injury. Patients with more severe coronary stenosis were more likely to have OSA, and they often had higher apnea-hypopnea index (AHI) and more central sleep apnea. Hypertension was independently associated with coronary stenosis and moderate to severe OSA after adjustment (=3.88, =0.035; =2.95, 0.046). Patients with more severe coronary stenosis had higher prevalence of OSA and more central sleep apnea affairs. Coronary heart disease patients with moderate to severe sleep apnea were more likely to develop aortic widening and abnormal right heart structure. Hypertension was an independent risk factor for severe coronary stenosis and moderate to severe OSA, respectively.
为进一步研究睡眠呼吸暂停与冠心病之间的关系。阻塞性睡眠呼吸暂停（OSA）与包括冠心病在内的多种心血管疾病相关。中重度OSA患者更容易出现更严重的冠状动脉狭窄。我们将血清学指标、超声心动图和冠状动脉造影结合起来，以进一步研究睡眠呼吸暂停与冠心病之间的关系。共纳入110例住院期间接受冠状动脉造影和夜间多导睡眠监测的冠心病患者，其中男性97例，女性13例，年龄27 - 85岁。收集了基线特征、生化检测、超声心动图、冠状动脉造影和多导睡眠监测的数据。采用t检验和非参数检验比较不同程度OSA患者心血管指标的差异。采用Logistic回归分析OSA和冠状动脉狭窄的危险因素。纳入的110例患者中位年龄为56岁。总体上，88.2%的患者为男性，84.5%患有OSA。中重度OSA患者睡眠期间心率变异性更大，升主动脉近端更宽，更易出现右心结构异常，然而，心肌损伤方面未发现显著差异。冠状动脉狭窄更严重的患者更易患OSA，且他们通常有更高的呼吸暂停低通气指数（AHI）和更多的中枢性睡眠呼吸暂停。调整后，高血压与冠状动脉狭窄及中重度OSA独立相关（β = 3.88，P = 0.035；β = 2.95，P = 0.046）。冠状动脉狭窄更严重的患者OSA患病率更高，中枢性睡眠呼吸暂停事件更多。中度至重度睡眠呼吸暂停的冠心病患者更易出现主动脉增宽和右心结构异常。高血压分别是严重冠状动脉狭窄和中度至重度OSA的独立危险因素。
