背景:高血压患者阻塞性睡眠呼吸暂停(OSA)与心律失常和心率变异性(HRV)发生之间的关系尚未阐明。我们的研究调查了OSA,心律失常,高血压患者的HRV。
方法:我们进行了一项横断面分析,根据呼吸暂停低通气指数(AHI)将高血压患者分为两组:AHI≤15和AHI>15。所有参与者都接受了多导睡眠图(PSG),24小时动态心电图(DCG),心脏多普勒超声,以及其他相关评价。
结果:AHI>15组频繁房性早搏和房性心动过速的患病率明显高于AHI≤15组(分别为P=0.030和P=0.035)。时域分析显示,AHI>15组正常-正常R-R间期(SDNN)的标准差和每5分钟正常-正常R-R间期(SDANN)的标准差明显高于对照组(P=0.020,P=0.033)。频域分析表明,低频(LF),高频(HF)元件,在AHI>15组中,LF/HF比率也显着升高(分别为P<0.001,P=0.031和P=0.028)。此外,AHI>15组左心房内径(LAD)明显增大(P<0.001)。单变量和多变量线性回归分析证实了PSG衍生的独立变量与相关HRV参数SDNN之间的显着关联,LF,和LF/HF比率(分别为F=8.929,P<0.001;F=14.832,P<0.001;F=5.917,P=0.016)。
结论:AHI>15的高血压患者发生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。
BACKGROUND: 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.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: Hypertensive patients with AHI > 15 are at an increased risk for atrial arrhythmias and left atrial dilation, with HRV significantly correlating with OSA severity.