Department of Cardiology, The Third Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, 230001, China.
Department of Sleep Monitoring Center, The Third Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, 230001, China.
BMC Cardiovasc Disord. 2024 Jul 4;24(1):338. doi: 10.1186/s12872-024-04008-5.
The relationship between obstructive sleep apnea (OSA) and the occurrence of arrhythmias and heart rate variability (HRV) in hypertensive patients is not elucidated. Our study investigates the association between OSA, arrhythmias, and HRV in hypertensive patients.
We conducted a cross-sectional analysis involving hypertensive patients divided based on their apnea-hypopnea index (AHI) into two groups: the AHI ≤ 15 and the AHI > 15. All participants underwent polysomnography (PSG), 24-hour dynamic electrocardiography (DCG), cardiac Doppler ultrasound, and other relevant evaluations.
The AHI > 15 group showed a significantly higher prevalence of frequent atrial premature beats and atrial tachycardia (P = 0.030 and P = 0.035, respectively) than the AHI ≤ 15 group. Time-domain analysis indicated that the standard deviation of normal-to-normal R-R intervals (SDNN) and the standard deviation of every 5-minute normal-to-normal R-R intervals (SDANN) were significantly higher in the AHI > 15 group (P = 0.020 and P = 0.033, respectively). Frequency domain analysis revealed that the low-frequency (LF), high-frequency (HF) components, and the LF/HF ratio were also significantly elevated in the AHI > 15 group (P < 0.001, P = 0.031, and P = 0.028, respectively). Furthermore, left atrial diameter (LAD) was significantly larger in the AHI > 15 group (P < 0.001). Both univariate and multivariable linear regression analyses confirmed a significant association between PSG-derived independent variables and the dependent HRV parameters SDNN, LF, and LF/HF ratio (F = 8.929, P < 0.001; F = 14.832, P < 0.001; F = 5.917, P = 0.016, respectively).
Hypertensive patients with AHI > 15 are at an increased risk for atrial arrhythmias and left atrial dilation, with HRV significantly correlating with OSA severity.
阻塞性睡眠呼吸暂停（OSA）与高血压患者心律失常和心率变异性（HRV）的发生之间的关系尚未阐明。我们的研究旨在探讨高血压患者中 OSA、心律失常和 HRV 之间的关系。
我们进行了一项横断面分析，将高血压患者根据呼吸暂停低通气指数（AHI）分为两组：AHI≤15 和 AHI＞15。所有参与者均接受多导睡眠图（PSG）、24 小时动态心电图（DCG）、心脏多普勒超声和其他相关评估。
AHI＞15 组频发房性早搏和房性心动过速的发生率明显高于 AHI≤15 组（P=0.030 和 P=0.035）。时域分析表明，正常窦性 R-R 间期标准差（SDNN）和每 5 分钟正常窦性 R-R 间期标准差（SDANN）在 AHI＞15 组中显著升高（P=0.020 和 P=0.033）。频域分析显示，低频（LF）、高频（HF）成分和 LF/HF 比值在 AHI＞15 组中也显著升高（P＜0.001、P=0.031 和 P=0.028）。此外，左心房直径（LAD）在 AHI＞15 组中明显更大（P＜0.001）。单变量和多变量线性回归分析均证实 PSG 衍生的独立变量与 SDNN、LF 和 LF/HF 比值等依赖 HRV 参数之间存在显著相关性（F=8.929，P＜0.001；F=14.832，P＜0.001；F=5.917，P=0.016）。
AHI＞15 的高血压患者发生心房性心律失常和左心房扩张的风险增加，HRV 与 OSA 严重程度显著相关。
