Andreas S, von Breska B, Schaumann A, Gonska B D, Kreuzer H
Dept of Cardiology and Pneumology, University of Göttingen, Germany.
Eur Respir J. 1995 Apr;8(4):546-50.
Patients with obstructive sleep apnoea demonstrate an increased rate of ventricular arrhythmias. The present study was designed in order to investigate whether these arrhythmias may be related to myocardial injury, since myocardial injury of various aetiologies has been observed to change the signal averaged electrocardiogram (ECG). Signal averaged ECG was registered in 23 patients with obstructive sleep apnoea diagnosed by polysomnography (apnoea index 43 +/- 20 events.h-1, age 55 +/- 10 yrs). QRS duration, root mean square voltage of the last 40 ms of QRS, and low amplitude (< 40 mV) signal duration were determined from the vector magnitude of the QRS, high-pass filtered at 40 Hz. Patients with coronary heart disease or bundle branch block were excluded. No patient showed an abnormal signal averaged ECG. Mean duration of the filtered QRS complex was 96 +/- 9 ms, root mean square voltage 38 +/- 18 microV and low amplitude signal duration 26 +/- 8 ms. These results were not significantly different from 14 snoring subjects with an apnoea/hypopnoea index < 10. Four patients showed no ventricular arrhythmias and six patients had Lown III or IVa in the Holter ECG. Echocardiography revealed increased left atrial (43.7 +/- 4.1 mm) and interventricular septal diameters (11.3 +/- 1.4 mm). In conclusion, obstructive sleep apnoea does not generate a substrate for late potentials in the signal averaged ECG.
阻塞性睡眠呼吸暂停患者的室性心律失常发生率增加。本研究旨在调查这些心律失常是否可能与心肌损伤有关，因为已观察到各种病因引起的心肌损伤会改变信号平均心电图（ECG）。对23例经多导睡眠图诊断为阻塞性睡眠呼吸暂停的患者（呼吸暂停指数43±20次/小时，年龄55±10岁）进行了信号平均心电图记录。从40Hz高通滤波后的QRS向量幅度中确定QRS持续时间、QRS最后40ms的均方根电压以及低振幅（<40mV）信号持续时间。排除患有冠心病或束支传导阻滞的患者。没有患者的信号平均心电图异常。滤波后的QRS波群平均持续时间为96±9ms，均方根电压为38±18μV，低振幅信号持续时间为26±8ms。这些结果与14名呼吸暂停/低通气指数<10的打鼾受试者没有显著差异。4例患者未出现室性心律失常，6例患者在动态心电图中出现Lown III级或IVa级。超声心动图显示左心房直径（43.7±4.1mm）和室间隔直径（11.3±1.4mm）增加。总之，阻塞性睡眠呼吸暂停不会在信号平均心电图中产生晚电位的基质。
