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急性缺血性卒中患者阻塞性睡眠呼吸暂停与心房颤动的关联:一项横断面研究。

Association of Obstructive Sleep Apnea and Atrial Fibrillation in Acute Ischemic Stroke: A Cross-Sectional Study.

作者信息

Brunetti Valerio, Testani Elisa, Losurdo Anna, Vollono Catello, Broccolini Aldobrando, Di Iorio Riccardo, Frisullo Giovanni, Pilato Fabio, Profice Paolo, Marotta Jessica, Rollo Eleonora, Scala Irene, Calabresi Paolo, Della Marca Giacomo

机构信息

UOC Neurologia, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, 00168 Rome, Italy.

Department of Neurosciences, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168 Rome, Italy.

出版信息

J Pers Med. 2023 Mar 15;13(3):527. doi: 10.3390/jpm13030527.

Abstract

: There is a growing body of evidence suggesting a link between obstructive sleep apnea (OSA) and atrial fibrillation (AF). The primary objective of this study is to evaluate the association between OSA and AF in acute ischemic stroke. The secondary objective is to describe the clinical features of patients with acute ischemic stroke and concomitant OSA. : We enrolled consecutive patients with acute ischemic stroke. All patients underwent full-night cardiorespiratory polygraphy. To determine if there is an association between AF and OSA, we compared the observed frequency of this association with the expected frequency from a random co-occurrence of the two conditions. Subsequently, patients with and without OSA were compared. : A total of 174 patients were enrolled (mean age 67.3 ± 11.6 years; 95 males). OSA and AF were present in 89 and 55 patients, respectively. The association OSA + AF was observed in 33/174 cases, which was not statistically different compared to the expected co-occurrence of the two conditions. Patients with OSA showed a higher neck circumference and body mass index, a higher prevalence of hypertension and dysphagia, and a higher number of central apneas/hypoapneas. In the multivariate analysis, dysphagia and hypertension were independent predictors of OSA. A positive correlation was observed between OSA severity, BMI, and neck circumference. The number of central apneas/hypoapneas was positively correlated with stroke severity. : Our data suggest that OSA and AF are highly prevalent but not associated in acute stroke. Our findings support the hypothesis that OSA acts as an independent risk factor for stroke.

摘要

越来越多的证据表明阻塞性睡眠呼吸暂停(OSA)与心房颤动(AF)之间存在联系。本研究的主要目的是评估急性缺血性卒中患者中OSA与AF之间的关联。次要目的是描述急性缺血性卒中和合并OSA患者的临床特征。

我们纳入了连续的急性缺血性卒中患者。所有患者均接受了全夜心肺多导睡眠监测。为了确定AF与OSA之间是否存在关联,我们将观察到的这种关联频率与两种情况随机同时出现时的预期频率进行了比较。随后,对有OSA和无OSA的患者进行了比较。

共纳入174例患者(平均年龄67.3±11.6岁;男性95例)。分别有89例和55例患者存在OSA和AF。在174例病例中有33例观察到OSA+AF的关联,与两种情况预期的同时出现相比,差异无统计学意义。有OSA的患者颈围和体重指数更高,高血压和吞咽困难的患病率更高,中枢性呼吸暂停/低通气次数更多。在多变量分析中,吞咽困难和高血压是OSA的独立预测因素。观察到OSA严重程度、BMI和颈围之间呈正相关。中枢性呼吸暂停/低通气次数与卒中严重程度呈正相关。

我们的数据表明,OSA和AF在急性卒中中非常普遍,但两者之间没有关联。我们的研究结果支持OSA是卒中独立危险因素的假设。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca73/10051494/6900a4faa8ab/jpm-13-00527-g001.jpg

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