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Clinical Investigations: CardiologyCardiac Rhythm Disturbances and ST-Segment Depression Episodes in Patients With Obstructive Sleep Apnea-Hypopnea Syndrome and Its Mechanisms*
Section snippets
Study Subjects
Twenty-one consecutive patients with OSAHS, 12 consecutive snorers without hypersomnolence (Epworth sleepiness scale < 5), and 15 age- and body mass index (BMI)-matched healthy subjects were selected for study. Patients were excluded from the study for the following reasons: (1) unwillingness or inability to perform the testing procedure; (2) obstructive or restrictive lung disease demonstrated on pulmonary function testing; (3) known valvular heart disease or hypertension, based on the mean of
Results
Anthropometric characteristics sleep architecture, lung function, and BP in patients with OSAHS, snorers, and control subjects are given in Table 1. There were no significant differences in gender, age, weight, height, BMI, or smoking habit among the three groups. The mean values of forced expiratory lung volumes, arterial blood gases, pH, hemoglobin concentration, and office BP were similar in all groups.
Daytime and nocturnal catecholamine concentrations in urine are also shown in Table 1.
Discussion
The main results of this study are the following: (1) patients with OSAHS have a higher frequency of most of the cardiac arrhythmias analyzed and ST-segment dynamic changes, in comparison with snoring and control subjects; and (2) ST-segment depression episodes are related to sleep fragmentation and sympathetic tone, whereas most of the rhythm disturbances in patients with OSAHS are associated with sleep fragmentation, nocturnal hypoxemia, and urinary catecholamine excretion.
There is
References (35)
- et al.
Long-term outcome for obstructive sleep apnea syndrome patients: mortality
Chest
(1988) - et al.
Sleep-related myocardial ischemia and sleep structure in patients with obstructive sleep apnea and coronary heart disease
Chest
(1997) - et al.
Nocturnal ischemic events in patients with obstructive sleep apnea syndrome and ischemic heart disease: effects of continuous positive air pressure treatment
J Am Coll Cardiol
(1999) - et al.
ST-segment depression during sleep in obstructive sleep apnea
Am J Cardiol
(1993) - et al.
Cardiac arrhythmia and conduction disturbances during sleep in 400 patients with sleep apnea syndrome
Am J Cardiol
(1983) - et al.
Cardiac rhythm disturbances in the obstructive sleep apnea syndrome: effects of nasal continuous positive airway pressure therapy
Chest
(2000) - et al.
White coat hypertension in patients with obstructive sleep apnea-hypopnea syndrome
Chest
(2004) - et al.
Sleep apnea and hypertension: the role of peripheral chemoreceptors and the sympathetic system
Chest
(2000) - et al.
Sleep apnoea and nocturnal angina
Lancet
(1995) - et al.
Spontaneous platelet activation and aggregation during obstructive sleep apnea and its response to therapy with nasal continuous positive airway pressure: a preliminary investigation
Chest
(1995)
Sleep-disordered breathing in women: occurrence and association with coronary artery disease
Am J Med
Sleep-disordered breathing in men with coronary artery disease
Chest
Cardiac arrhythmias, snoring, and sleep apnea
Chest
Relations among hypoxemia, sleep stage, and bradyarrhythmia during obstructive sleep apnea
Am Heart J
The occurrence of sleep-disordered breathing among middle-aged adults
N Engl J Med
Increased incidence of cardiovascular disease in middle-aged men with obstructive sleep apnea: a 7-year follow-up
Am J Respir Crit Care Med
Prospective study of the association between sleep-disordered breathing and hypertension
N Engl J Med
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Supported by grants from Fondo de Investigaciones Sanitarias (96/1280, 99/0252, 01/0276, and 01/0278) and Neumomadrid (2000).
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (e-mail: [email protected]).
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From Servicios de Neumología (Drs. Alonso-Fern´ndez, García-Río, Pino, and Villamor), Cardiología (Dr. Ortuño), and Laboratorio de Bioquímica (Dr. Martínez), Hospital Universitario La Paz; and Sección de Neumología (Dr. Racionero), Hospital de Alcorcón, Alcorcón, Madrid, Spain.