Individual periodic limb movements with arousal are temporally associated with nonsustained ventricular tachycardia: a case-crossover analysis.
Individual periodic limb movements with arousal are temporally associated with nonsustained ventricular tachycardia: a case-crossover analysis.
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伴有唤醒的个体周期性肢体运动在时间上与非持续性室性心动过速相关：病例交叉分析。
DOI：
10.1093/sleep/zsz165
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发表时间：
2019
期刊：
影响因子：
5.6
通讯作者：
OsteoporoticFracturesinMen(MrOS)StudyGroup
中科院分区：
文献类型：
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作者：
May,AnnaM;May,RyanD;Bena,James;Wang,Lu;Monahan,Ken;Stone,KatieL;Barrett-Connor,Elizabeth;Koo,BrianB;Winkelman,JohnW;Redline,Susan;Mittleman,MurrayA;Mehra,Reena;OsteoporoticFracturesinMen(MrOS)StudyGroup
研究目的睡眠期周期性肢体运动（PLMS）和觉醒都与交感神经系统激活有关，可能是致痫性的。我们假设一个时间的关系存在于个人PLMS，特别是与觉醒，和非持续性室性心动过速（NSVT）events.MethodsA双向时间分层的情况下，交叉设计被用来评估时间之间的关联PLMS和NSVT在睡眠中49骨质疏松性骨折男性睡眠研究参与者与NSVT在社区为基础的队列（n= 2,911）。睡眠时间被分为大约30分钟的片段。对于每一个NSVT（n= 141），我们选择了一个前30秒的危险期和三个随机选择的30秒的控制期，从睡眠在同一段和评估PLMS，呼吸事件，最低饱和度，和觉醒。优势比和95%置信区间-OR（95%CI）-通过条件logistic回归确定;协变量包括EEG觉醒、最小饱和度和同一危险/对照期的呼吸事件。结果患有NSVT的参与者年龄为79.5 ± 6.2岁，PLMS指数为32.1（IQR：10.1，61.4）和呼吸暂停低通气指数17.1（IQR：9.4，26.1）。无觉醒的PLMS与NSVT无显著相关性（OR = 0.80，95%CI：0.41-1.59）。在未校正分析中（OR = 2.50，95%CI：1.11-5.65）和校正后（OR = 2.31，95%CI：1.02-5.25），伴觉醒的PLMS与NSVT相关。在未校正（OR = 2.84，95%CI：1.23-6.56）和校正分析（OR = 2.61，95%CI：1.13-6.05）中，与PLMS相关的觉醒与NSVT相关。PLMS相关觉醒可能是生理学上重要的室性心律失常触发因素。临床试验RegistrationClinicalTrials.gov，NCT 00070681。
Study ObjectivesBoth periodic limb movements during sleep (PLMS) and arousals are associated with sympathetic nervous system activation and may be arrhythmogenic. We hypothesize a temporal relationship exists between individual PLMS, particularly with arousal, and nonsustained ventricular tachycardia (NSVT) events.MethodsA bidirectional time-stratified case-crossover design was used to assess temporal associations between PLMS and NSVT during sleep in 49 Osteoporotic Fractures in Men Sleep Study participants with NSVT in a community-based cohort (n= 2,911). Sleep time was divided into approximate 30-min segments. For each NSVT (n= 141), we selected a preceding 30-s hazard period and three randomly chosen 30-s control periods from sleep within the same segment and evaluated for PLMS, respiratory events, minimum saturation, and arousals. Odds ratios and 95% confidence intervals—OR (95% CI)—were determined by conditional logistic regression; covariates included EEG arousals, minimum saturation, and respiratory events in the same hazard/control period.ResultsParticipants with NSVT were 79.5 ± 6.2 years with a PLMS index of 32.1 (IQR: 10.1, 61.4) and apnea–hypopnea index of 17.1 (IQR: 9.4, 26.1). PLMS without arousal were not significantly associated with NSVT (OR = 0.80, 95% CI: 0.41–1.59). PLMS with arousal were associated with NSVT in unadjusted analyses (OR = 2.50, 95% CI: 1.11–5.65) and after adjustment (OR = 2.31, 95% CI: 1.02–5.25). Arousals associated with PLMS were associated with NSVT in unadjusted (OR = 2.84, 95% CI: 1.23–6.56) and adjusted analyses (OR = 2.61, 95% CI: 1.13–6.05).ConclusionsPLMS with (but not without) arousals are temporally associated with a greater than twofold higher odds of subsequent NSVT episodes. PLMS-related arousals may be physiologically important ventricular arrhythmia triggers.Clinical Trial RegistrationClinicalTrials.gov, NCT00070681.