Obstructive sleep apnea is associated with increased QT corrected interval dispersion: the effects of continuous positive airway pressure.

Nagihan Bilal,Aylin Sungur,Israfil Orhan,Anil Samur,Selman Sarica,Fulsen Bozkus,Nursel Dikmen

doi:10.1016/j.bjorl.2017.03.005

Abstract

IntroductionSevere obstructive sleep apnea is associated with increased QT corrected interval dispersion and continuous positive airway pressure is thought to improve this arrhythmogenic marker.ObjectiveThe aim of the study was to determine the decrease of ratio of cardiovascular risk in patients with obstructive sleep apnea.MethodsThe study included 65 patients with severe obstructive sleep apnea who had an apnea-hypopnea index score of >30. Each patient underwent 12-channel electrocardiogram monitoring and polysomnography. Patients with an apnea-hypopnea index score of <5 were used as the control group. The control group also underwent electrocardiogram monitoring and polysomnography testing. The QT corrected interval dispersion levels of both groups were calculated. Three months after continuous positive airway pressure treatment, electrocardiogram recordings were obtained from the 65 patients with severe obstructive sleep apnea again, and their QT corrected interval dispersion values were calculated.ResultsThere were 44 male and 21 female patients with severe obstructive sleep apnea syndrome. The age, gender, body mass index, initial saturation, minimum saturation, average saturation, and desaturation index were determined in both groups. The QT corrected intervals of the obstructive sleep apnea patients (62.48 ± 16.29 ms) were significantly higher (p = 0.001) than those of the control group (29.72 ± 6.30 ms). There were statistically significant differences between the QT corrected values before and after the continuous positive airway pressure treatment, with pretreatment QT corrected intervals of 62.48 ± 16.29 ms and 3-month post-treatment values of 41.42 ± 16.96 ms (p = 0.001). There was a positive and significant correlation between QT corrected interval dispersion periods and the apnea-hypopnea index and hypopnea index in obstructive sleep apnea patients (p = 0.001; r = 0.71; p = 0.001; r = 0.679, respectively).ConclusionContinuous positive airway pressure treatment reduced the QT corrected interval dispersion in patients with severe obstructive sleep apnea. In addition, shortening the QT corrected interval dispersion periods in patients with severe obstructive sleep apnea may reduce their risk of arrhythmias and cardiovascular disease.

Highlights

Severe obstructive sleep apnea is associated with increased QT corrected interval dispersion and continuous positive airway pressure is thought to improve this arrhythmogenic marker
There were no significant differences between the Obstructive sleep apnea (OSA) patients and the control group with respect to gender, age, and body mass index (BMI)
The start saturation, minimum saturation, and average saturation were higher in the control group than in the OSA patients, with significant between-group differences detected (p = 0.001)

Summary

Introduction

Severe obstructive sleep apnea is associated with increased QT corrected interval dispersion and continuous positive airway pressure is thought to improve this arrhythmogenic marker. Three months after continuous positive airway pressure treatment, electrocardiogram recordings were obtained from the 65 patients with severe obstructive sleep apnea again, and their QT corrected interval dispersion values were calculated. Obstructive sleep apnea (OSA) is characterized by repeated episodes of partial (hypopnea) or full (apnea) obstruction of the upper airway during sleep These events usually cause a reduction in blood oxygen saturation and generally finish with brief arousals.[1] According to recent epidemiological studies, the prevalence of OSA increases according to body mass index (BMI), gender, age and apnea-hypopnea index (AHI).[2] When OSA prevalence is examined at AHI > 15, the rates have been reported as 10---17% in males and 3---9% in females.[2] The AHI classifies the intensity of OSA and is based on the number of apnea and hypopnea events per hour of sleep per night.[3] OSA is more frequent in middle-aged male patients and in those with arterial hypertension, heart failure, ischemic heart disease, and stroke.[4,5] Previous studies have stated the estimated risk of coronary artery disease in OSA patients, especially males, as 37%.6

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