Vascular Health and Risk Management (Nov 2023)

Cross-Sectional Relationship Between Atrial Conduction Delay and Arterial Stiffness in Patients with Obstructive Sleep Apnea

  • Ueda A,
  • Kasagi S,
  • Maeno K,
  • Naito R,
  • Kumagai T,
  • Kimura Y,
  • Kato M,
  • Kawana F,
  • Tomita Y,
  • Narui K,
  • Kasai T

Journal volume & issue
Vol. Volume 19
pp. 733 – 740

Abstract

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Azusa Ueda,1,2 Satoshi Kasagi,2 Ken-ichi Maeno,2,3 Ryo Naito,4– 6 Takiko Kumagai,1,2 Yuka Kimura,1,2 Mitsue Kato,1,2,4 Fusae Kawana,1,2,4 Yasuhiro Tomita,2,5,6 Koji Narui,2,4 Takatoshi Kasai2,4– 6 1Clinical Physiology, Toranomon Hospital, Tokyo, Japan; 2Department of Sleep Respiratory Medicine, Toranomon Hospital, Tokyo, Japan; 3Department of Cardiovascular Medicine, Japanese Red Cross Ise Hospital, Mie, Japan; 4Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; 5Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; 6Sleep and Sleep Disordered Breathing Center, Juntendo University Hospital, Tokyo, JapanCorrespondence: Satoshi KasagiSleep Respiratory Medicine, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan, Tel +81-3-3588-1111, Fax +81-3-3560-7815, Email [email protected]: Prolonged P-wave duration (PWD), which indicates atrial conduction delay, is a potent precursor of atrial fibrillation (AF) that may be induced by obstructive sleep apnea (OSA). The cardio-ankle vascular index (CAVI), which is an arterial stiffness parameter, is elevated in patients with OSA; moreover, an increased CAVI is associated with atrial conduction delay through left atrium enlargement in association with left ventricular diastolic dysfunction. We aimed to examine the relationship between the CAVI and PWD in patients with OSA.Methods: We included patients with a sinus rhythm who underwent overnight polysomnography. We measured the PWD and CAVI on standard 12-lead electrocardiograms; further, we analyzed the relationship between PWD and CAVI.Results: We analyzed data from 300 participants (men, 89.0%; mean age, 52.3 ± 13.1 years; and body mass index, 26.2 ± 3.9 kg/m2). The mean PWD was 104.4 ± 10.4 ms while the mean CAVI was 7.5 ± 1.5. PWD was significantly correlated with CAVI (r = 0.478, p < 0.001); additionally, PWD and CAVI were directly associated with OSA severity (p = 0.002 and p = 0.002, respectively). Multivariate regression analysis revealed an independent significant correlation of PWD and CAVI with OSA severity.Conclusion: In patients with OSA, an increase in arterial stiffness is associated with atrial conduction delay.Keywords: atrial fibrillation, cardio-ankle vascular index, obstructive sleep apnea, P-wave duration

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