A Study on the Diurnal Variation of Ventricular Repolarization Parameters in Patients with Obstructive Sleep Apnea

Abstract

BackgroundObstructive sleep apnea hypopnea syndrome (OSAHS) is a common sleep breathing disorder. More and more studies have shown that OSAHS has a significant correlation with cardiovascular disease. It is an independent risk factor for arrhythmia, hypertension, coronary heart disease and other cardiovascular diseases, but the specific mechanism is still not completely clear. Relevant evidence indicates that ventricular repolarization parameters such as Tp-e interval, QT interval and Tp-e/QT ratio may be related to arrhythmia and even sudden cardiac death. However, up to now, there are relatively few studies on OSAHS-related arrhythmias and changes in cardiac electrical parameters.ObjectiveTo study the diurnal variation of ventricular repolarization parameters in patients with obstructive sleep apnea.MethodA total of 159 OSAHS patients who met the inclusion criteria and received polysomnography monitoring in the First Affiliated Hospital of Zhengzhou University from June 2020 to July 2021 were selected as the observation group, further divided into mild-moderate OSAHS group (n=78) and severe OSAHS group (n=81) according to the severity. Fifty-one healthy people without disease were selected as the control group. Daytime and nocturnal Tp-e interval, QT interval, Tp-e/QT ratio were measured and calculated for all participants.ResultsThere were significant differences in daytime Tp-e interval, nocturnal Tp-e interval, daytime Tp-e/QT ratio, nocturnal Tp-e/QT ratio among the control group、the mild-moderate OSAHS group and the severe OSAHS group (P<0.001) . In addition, the daytime Tp-e interval, nocturnal Tp-e interval, daytime Tp-e/QT ratio and nocturnal Tp-e/QT ratio have a gradually increasing trend among the three groups (P<0.05) . There were no significant differences in daytime QT interval and nocturnal QT interval among the three groups (P>0.05) .Tp-e interval, QT interval, Tp-e/QT ratiosin the observation group were statistically different between daytime resting state and nocturnal obstructive state (P<0.05) ; The Tp-e interval, QT interval, and Tp-e/QT ratio in nocturnal obstructive state were significantly longer than those in daytime resting state (P<0.05) .The nocturnal Tp-e interval (rs=0.221, P=0.005) and nocturnal Tp-e /QT (rs=0.298, P<0.001) of OSAHS patients were positively correlated with AHI.ConclusionVentricular repolarization parameters in OSAHS patients during nocturnal obstructive apnea are longer than those in daytime resting state, and the diurnal variation is significant, which provides a new idea for the future study of OSAHS with arrhythmia.

Keywords

• |obstructive sleep apnea hypopnea syndrome|tp-e interval|qt interval|tp-e/qt ratio|ventricular repolarization parameters