Öz
Aim: Obstructive sleep apnea syndrome (OSAS) is a prevalent sleep condition marked by recurrent upper airway blockages causing intermittent hypoxia, fragmented sleep, and autonomic nervous system issues. Significant emphasis has been paid to the connection between OSAS and the development of ventricular arrhythmias in recent years. The index of cardiac electrophysiological balance (ICEB) represents a new measure designed to predict the likelihood of ventricular arrhythmias.
Material and Methods: Forty OSAS patients and 40 healthy controls were enrolled in the research. Clinical and demographic variables of both groups were evaluated. Electrocardiogram was taken and routine blood values of the patients were studied. The ICEB is computed by dividing the QT interval by the QRS duration (QT/QRS). Apnea-hypopnea index was used to evaluate the severity of OSAS.
Results: The body-mass index value of OSAS patients was significantly higher than HCs (p=0.002). No significant smoking status difference between OSAS patients and HCs (p=0.822). As a result, QT, QTc, and ICEB were substantially greater in OSAS patients than in HCs (p<0.001, for all). According to Pearson correlation analysis, apnea-hypopnea index and body-mass index, QT, QTc, and ICEB were significantly correlated (p=0.020, p=0.009, p=0.010, and p=0.003, respectively). In linear regression analysis where the apnea-hypopnea index was taken as a dependent variable, ICEB predicted the apnea-hypopnea index significantly and positively (F(5.76)=18.451, R2=0.657, adjusted R2=0.715 and p<0.001).
Conclusion: In this study, a positive and significant relationship was found between the AHI value, which is used to evaluate the severity of OSAS, and ICEB. The fact that ICEB, which is used to evaluate the risk of ventricular arrhythmia, is higher in OSAS patients indicates that these patients should be followed more closely in the cardiologic outpatient clinic.
Anahtar Kelimeler
Index of cardiac electrophysiological balance Obstructive sleep apnea syndrome Ventricular arrhythmia
Kaynakça
- Mannarino MR, Di Filippo F, Pirro M. Obstructive sleep apnea syndrome. Eur J Intern Med. 2012;23:586-93.
- John RM, Tedrow UB, Koplan BA, et al. Ventricular arrhythmias and sudden cardiac death. Lancet. 2012;380:1520-9.
- Marinheiro R, Parreira L, Amador P, et al. Ventricular arrhythmias in patients with obstructive sleep apnea. Curr Cardiol Rev. 2019;15:64-74.
- Raghuram A, Clay R, Kumbam A, Tereshchenko LG, Khan A. A systematic review of the association between obstructive sleep apnea and ventricular arrhythmias. J Clin Sleep Med. 2014;10:1155-60.
- Yücetas SC, Kaya H, Kafadar S, et al. Evaluation of index of cardiac-electrophysiological balance in patients with subarachnoid hemorrhage. BMC Cardiovasc Disord. 2022;22:477.
- Kaya H, Suner A, Koparal M, et al. Evaluation of Tp-e interval, Tp-e/QT ratio and index of cardiac-electrophysiological balance in patients with tinnitus. BMC Cardiovasc Disord. 2021;21:415.
- Malhotra A, Ayappa I, Ayas N, et al. Metrics of sleep apnea severity: beyond the apnea-hypopnea index. Sleep. 2021;44:zsab030.
- Wall H, Smith C, Hubbard R. Body mass index and obstructive sleep apnoea in the UK: a cross-sectional study of the over-50s. Prim Care Respir J. 2012;21:371-6.
- Hesselbacher S, Subramanian S, Allen J, et al. Body mass index, gender, and ethnic variations alter the clinical implications of the epworth sleepiness scale in patients with suspected obstructive sleep apnea. Open Respir Med J. 2012;6:20-7.
- Gillis AM, Stoohs R, Guilleminault C. Changes in the QT interval during obstructive sleep apnea. Sleep. 1991;14:346-50.
- Barta K, Szabó Z, Kun C, et al. The effect of sleep apnea on QT interval, QT dispersion, and arrhythmias. Clin Cardiol. 2010;33:E35-9.
- Beach SR, Celano CM, Sugrue AM, et al. QT prolongation, torsades de pointes, and psychotropic medications: a 5-year update. Psychosomatics. 2018;59:105-22.
- Baumert M, Smith J, Catcheside P, et al. Variability of QT interval duration in obstructive sleep apnea: an indicator of disease severity. Sleep. 2008;31:959-66.
- Çiçek D, Lakadamyali H, Gökay S, et al. Effect of obstructive sleep apnea on heart rate, heart rate recovery and QTc and P-wave dispersion in newly diagnosed untreated patients. Am J Med Sci. 2012;344:180-5.
- Arias MA, Sánchez AM. Obstructive sleep apnea and its relationship to cardiac arrhythmias. J Cardiovasc Electrophysiol. 2007;18:1006-14.
- Franciosi S, Perry FKG, Roston TM, et al. The role of the autonomic nervous system in arrhythmias and sudden cardiac death. Auton Neurosci. 2017;205:1-11.
- Fukui S, Katoh H, Tsuzuki N, et al. Multivariate analysis of risk factors for QT prolongation following subarachnoid hemor- rhage. Crit Care. 2003;7:R7-12.
- Vanhecke TE, Franklin BA, Zalesin KC, et al. Cardiorespiratory fitness and obstructive sleep apnea syndrome in morbidly obese patients. Chest. 2008;134:539-45.
- Bisogni V, Pengo MF, Maiolino G, Rossi GP. The sympathetic nervous system and catecholamines metabolism in obstructive sleep apnoea. J Thorac Dis. 2016;8:243-54.
- Zhang M, Zhang W, Tan J, et al. Role of hypothyroidism in obstructive sleep apnea: a meta-analysis. Curr Med Res Opin. 2016;32:1059-64.
Öz
Kaynakça
- Mannarino MR, Di Filippo F, Pirro M. Obstructive sleep apnea syndrome. Eur J Intern Med. 2012;23:586-93.
- John RM, Tedrow UB, Koplan BA, et al. Ventricular arrhythmias and sudden cardiac death. Lancet. 2012;380:1520-9.
- Marinheiro R, Parreira L, Amador P, et al. Ventricular arrhythmias in patients with obstructive sleep apnea. Curr Cardiol Rev. 2019;15:64-74.
- Raghuram A, Clay R, Kumbam A, Tereshchenko LG, Khan A. A systematic review of the association between obstructive sleep apnea and ventricular arrhythmias. J Clin Sleep Med. 2014;10:1155-60.
- Yücetas SC, Kaya H, Kafadar S, et al. Evaluation of index of cardiac-electrophysiological balance in patients with subarachnoid hemorrhage. BMC Cardiovasc Disord. 2022;22:477.
- Kaya H, Suner A, Koparal M, et al. Evaluation of Tp-e interval, Tp-e/QT ratio and index of cardiac-electrophysiological balance in patients with tinnitus. BMC Cardiovasc Disord. 2021;21:415.
- Malhotra A, Ayappa I, Ayas N, et al. Metrics of sleep apnea severity: beyond the apnea-hypopnea index. Sleep. 2021;44:zsab030.
- Wall H, Smith C, Hubbard R. Body mass index and obstructive sleep apnoea in the UK: a cross-sectional study of the over-50s. Prim Care Respir J. 2012;21:371-6.
- Hesselbacher S, Subramanian S, Allen J, et al. Body mass index, gender, and ethnic variations alter the clinical implications of the epworth sleepiness scale in patients with suspected obstructive sleep apnea. Open Respir Med J. 2012;6:20-7.
- Gillis AM, Stoohs R, Guilleminault C. Changes in the QT interval during obstructive sleep apnea. Sleep. 1991;14:346-50.
- Barta K, Szabó Z, Kun C, et al. The effect of sleep apnea on QT interval, QT dispersion, and arrhythmias. Clin Cardiol. 2010;33:E35-9.
- Beach SR, Celano CM, Sugrue AM, et al. QT prolongation, torsades de pointes, and psychotropic medications: a 5-year update. Psychosomatics. 2018;59:105-22.
- Baumert M, Smith J, Catcheside P, et al. Variability of QT interval duration in obstructive sleep apnea: an indicator of disease severity. Sleep. 2008;31:959-66.
- Çiçek D, Lakadamyali H, Gökay S, et al. Effect of obstructive sleep apnea on heart rate, heart rate recovery and QTc and P-wave dispersion in newly diagnosed untreated patients. Am J Med Sci. 2012;344:180-5.
- Arias MA, Sánchez AM. Obstructive sleep apnea and its relationship to cardiac arrhythmias. J Cardiovasc Electrophysiol. 2007;18:1006-14.
- Franciosi S, Perry FKG, Roston TM, et al. The role of the autonomic nervous system in arrhythmias and sudden cardiac death. Auton Neurosci. 2017;205:1-11.
- Fukui S, Katoh H, Tsuzuki N, et al. Multivariate analysis of risk factors for QT prolongation following subarachnoid hemor- rhage. Crit Care. 2003;7:R7-12.
- Vanhecke TE, Franklin BA, Zalesin KC, et al. Cardiorespiratory fitness and obstructive sleep apnea syndrome in morbidly obese patients. Chest. 2008;134:539-45.
- Bisogni V, Pengo MF, Maiolino G, Rossi GP. The sympathetic nervous system and catecholamines metabolism in obstructive sleep apnoea. J Thorac Dis. 2016;8:243-54.
- Zhang M, Zhang W, Tan J, et al. Role of hypothyroidism in obstructive sleep apnea: a meta-analysis. Curr Med Res Opin. 2016;32:1059-64.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Kulak Burun Boğaz |
| Bölüm | Özgün Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 19 Ekim 2023 |
| Kabul Tarihi | 13 Eylül 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 5 Sayı: Supplement (1) - Innovations in Medicine and Healthcare in the 100th Year of the Republic |
Chief Editors
Assoc. Prof. Zülal Öner
Address: İzmir Bakırçay University, Department of Anatomy, İzmir, Turkey
Assoc. Prof. Deniz Şenol
Address: Düzce University, Department of Anatomy, Düzce, Turkey
E-mail: medrecsjournal@gmail.com
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Medical Records Association (Tıbbi Kayıtlar Derneği)
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