Electrocardiographic parameters of myocardial electrical instability in patients with obstructive sleep apnea-hypopnea syndrome and newly diagnosed arterial hypertension
https://doi.org/10.18705/1607-419X-2015-21-3-301-308
Abstract
Objective. To study the rate of long QTc and JTc intervals in sleep-wakefulness cycle, and also their relationship with severity of obstructive sleep apnea-hypopnea syndrome (OSA) in patients with newly diagnosed hypertension (HTN).
Design and methods. 24‑hour multifunctional monitoring was conducted in 59 male patients (age 38,0 ± 7,7 years old; body mass index 33,8 ± 5,4 kg/m 2) with elevated office blood pressure, who did not receive any medications. All patients had two or more risk factors of HTN. Organ damage was identified in 12 (20 %) patients. The long QTc interval was defined as 450 msec or more, automatic analysis was performed using 8‑lead dynamic ECG.
Results. OSA was diagnosed in 40 (68 %) patients: 17 patients had mild sleep apnea (apneahypopnea index, AHI, from 5 to 14 episodes per hour), the rest of the patients had moderate and severe OSA (AHI from 18 to 97 episodes per hour). Nineteen (32 %) patients without OSA were included in the comparison group (AHI less than 5 episodes per hour). There was no differences in average heart rate during assessed time periods between the groups. There was a direct positive correlation between duration of QTc and JTc calculated separately for periods of wakefulness, sleep and AHI and hypoxemia index.
Conclusions. More than 50 % of patients with newly diagnosed AH and OSA without associated cardiovascular diseases demonstrate changes in myocardial repolarization throughout sleep-wakefulness cycle. These changes are associated with the number of apneas/hypopneas and the severity of hypoxemia during sleep
About the Authors
N. V. Borodin
Voronezh State Medical University named after N. N. Burdenko, Voronezh, Russia 10 Studencheskaya street, 394036. Tel: +7(473)253–12–22. Fax: +7(473)253–00–05
Russian Federation
Russian Federation
MD, Postgraduate Student, Department of Faculty Therapy, Voronezh N. N. Burdenko State Medical Academy
O. V. Lyshova
Voronezh State Medical University named after N. N. Burdenko, Voronezh, Russia 10 Studencheskaya street, 394036. Tel: +7(473)253–12–22. Fax: +7(473)253–00–05
Russian Federation
Russian Federation
MD, PhD, Professor, Department of Faculty Therapy, Voronezh N. N. Burdenko State Medical Academy
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For citations:
Borodin N.V., Lyshova O.V. Electrocardiographic parameters of myocardial electrical instability in patients with obstructive sleep apnea-hypopnea syndrome and newly diagnosed arterial hypertension. "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 2015;21(3):301-308. (In Russ.) https://doi.org/10.18705/1607-419X-2015-21-3-301-308
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