Xu Haobo, Wang Juan, Qiao Shubin, Yuan Jiansong, Hu Fenghuan, Yang Weixian, Guo Chao, Luo Xiaoliang, Duan Xin, Liu Shengwen, Liu Rong, Cui Jingang
Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing 100037, China.
J Clin Med. 2023 Feb 8;12(4):1347. doi: 10.3390/jcm12041347.
Data regarding the association between sleep apnea (SA) and atrial fibrillation (AF) in hypertrophic cardiomyopathy (HCM) are still limited. We aim to investigate the association of both types of SA, obstructive sleep apnea (OSA) and central sleep apnea (CSA), and nocturnal hypoxemia with AF in HCM.
A total of 606 patients with HCM who underwent sleep evaluations were included. Logistic regression was used to assess the association between sleep disorder and AF.
SA was presented in 363 (59.9%) patients, of whom 337 (55.6%) had OSA and 26 (4.3%) had CSA. Patients with SA were older, more often male, had a higher body mass index, and more clinical comorbidities. Prevalence of AF was higher in patients with CSA than patients with OSA and without SA (50.0% versus 24.9% and 12.8%, < 0.001). After adjustment for age, sex, body mass index, hypertension, diabetes mellitus, cigarette use, New York Heart Association class and severity of mitral regurgitation, SA (OR, 1.79; 95% CI, 1.09-2.94) and nocturnal hypoxemia (higher tertile of percentage of total sleep time with oxygen saturation < 90% [OR, 1.81; 95% CI, 1.05-3.12] compared with lower tertile) were significantly associated with AF. The association was much stronger in the CSA group (OR, 3.98; 95% CI, 1.56-10.13) than in OSA group (OR, 1.66; 95% CI, 1.01-2.76). Similar associations were observed when analyses were restricted to persistent/permanent AF.
Both types of SA and nocturnal hypoxemia were independently associated with AF. Attention should be paid to the screening of both types of SA in the management of AF in HCM.
关于肥厚型心肌病（HCM）中睡眠呼吸暂停（SA）与心房颤动（AF）之间关联的数据仍然有限。我们旨在研究两种类型的SA，即阻塞性睡眠呼吸暂停（OSA）和中枢性睡眠呼吸暂停（CSA），以及夜间低氧血症与HCM中AF的关联。
共纳入606例接受睡眠评估的HCM患者。采用逻辑回归评估睡眠障碍与AF之间的关联。
363例（59.9%）患者存在SA，其中337例（55.6%）患有OSA，26例（4.3%）患有CSA。SA患者年龄更大，男性更常见，体重指数更高，临床合并症更多。CSA患者的AF患病率高于OSA患者和无SA患者（50.0%对24.9%和12.8%，P<0.001）。在调整年龄、性别、体重指数、高血压、糖尿病、吸烟、纽约心脏协会分级和二尖瓣反流严重程度后，SA（比值比[OR]，1.79；95%置信区间[CI]，1.09 - 2.94）和夜间低氧血症（总睡眠时间中氧饱和度<90%的百分比处于较高三分位数[OR，1.81；95%CI，1.05 - 3.12]与较低三分位数相比）与AF显著相关。CSA组的关联（OR，3.98；95%CI，1.56 - 10.13）比OSA组（OR，1.66；95%CI，1.01 - 2.76）更强。当分析仅限于持续性/永久性AF时，观察到类似的关联。
两种类型的SA和夜间低氧血症均与AF独立相关。在HCM患者AF的管理中，应注意对两种类型SA的筛查。
