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Beat-to-beat cardiac repolarization lability increases during hypoxemia and arousals in obstructive sleep apnea patients.
Ebrahimian, Serajeddin; Sillanmäki, Saara; Hietakoste, Salla; Kulkas, Antti; Töyräs, Juha; Bailón, Raquel; Hernando, David; Lombardi, Carolina; Grote, Ludger; Bonsignore, Maria R; Saaresranta, Tarja; Pépin, Jean-Louis; Leppänen, Timo; Kainulainen, Samu.
Afiliação
  • Ebrahimian S; Department of Technical Physics, University of Eastern Finland, Kuopio, Finland.
  • Sillanmäki S; Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland.
  • Hietakoste S; Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland.
  • Kulkas A; Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
  • Töyräs J; Department of Technical Physics, University of Eastern Finland, Kuopio, Finland.
  • Bailón R; Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland.
  • Hernando D; Department of Technical Physics, University of Eastern Finland, Kuopio, Finland.
  • Lombardi C; Department of Clinical Neurophysiology, Seinäjoki Central Hospital, Seinäjoki, Finland.
  • Grote L; Department of Technical Physics, University of Eastern Finland, Kuopio, Finland.
  • Bonsignore MR; School of Electrical Engineering and Computer Science, The University of Queensland, Brisbane, Australia.
  • Saaresranta T; Science Service Center, Kuopio University Hospital, Kuopio, Finland.
  • Pépin JL; Biomedical Signal Interpretation and Computational Simulation (BSICoS) Group, Aragón Institute of Engineering Research (I3A), IIS Aragón, University of Zaragoza, Zaragoza, Spain.
  • Leppänen T; Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain.
  • Kainulainen S; Biomedical Signal Interpretation and Computational Simulation (BSICoS) Group, Aragón Institute of Engineering Research (I3A), IIS Aragón, University of Zaragoza, Zaragoza, Spain.
Am J Physiol Heart Circ Physiol ; 326(5): H1094-H1104, 2024 05 01.
Article em En | MEDLINE | ID: mdl-38426864
ABSTRACT
Obstructive sleep apnea (OSA) is associated with the progression of cardiovascular diseases, arrhythmias, and sudden cardiac death (SCD). However, the acute impacts of OSA and its consequences on heart function are not yet fully elucidated. We hypothesized that desaturation events acutely destabilize ventricular repolarization, and the presence of accompanying arousals magnifies this destabilization. Ventricular repolarization lability measures, comprising heart rate corrected QT (QTc), short-time-variability of QT (STVQT), and QT variability index (QTVI), were calculated before, during, and after 20,955 desaturations from lead II electrocardiography signals of 492 patients with suspected OSA (52% men). Variations in repolarization parameters were assessed during and after desaturations, both with and without accompanying arousals, and groupwise comparisons were performed based on desaturation duration and depth. Regression analyses were used to investigate the influence of confounding factors, comorbidities, and medications. The standard deviation (SD) of QT, mean QTc, SDQTc, and STVQT increased significantly (P < 0.01), whereas QTVI decreased (P < 0.01) during and after desaturations. The changes in SDQT, mean QTc, SDQTc, and QTVI were significantly amplified (P < 0.01) in the presence of accompanying arousals. Desaturation depth was an independent predictor of increased SDQTc (ß = 0.405, P < 0.01), STVQT (ß = 0.151, P < 0.01), and QTVI (ß = 0.009, P < 0.01) during desaturation. Desaturations cause acute changes in ventricular repolarization, with deeper desaturations and accompanying arousals independently contributing to increased ventricular repolarization lability. This may partially explain the increased risk of arrhythmias and SCD in patients with OSA, especially when the OSA phenotype includes high hypoxic load and fragmented sleep.NEW & NOTEWORTHY Nocturnal desaturations are associated with increased ventricular repolarization lability. Deeper desaturations with accompanying arousals increase the magnitude of alterations, independent of confounding factors, comorbidities, and medications. Changes associated with desaturations can partially explain the increased risk of arrhythmias and sudden cardiac death in patients with OSA, especially in patients with high hypoxic load and fragmented sleep. This highlights the importance of detailed electrocardiogram analytics for patients with OSA.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Arritmias Cardíacas / Apneia Obstrutiva do Sono Limite: Female / Humans / Male Idioma: En Revista: Am J Physiol Heart Circ Physiol Assunto da revista: CARDIOLOGIA / FISIOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Finlândia

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Arritmias Cardíacas / Apneia Obstrutiva do Sono Limite: Female / Humans / Male Idioma: En Revista: Am J Physiol Heart Circ Physiol Assunto da revista: CARDIOLOGIA / FISIOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Finlândia