Relation of Obstructive Sleep Apnea and a Common Variant at Chromosome 4q25 to Atrial Fibrillation.
Relation of Obstructive Sleep Apnea and a Common Variant at Chromosome 4q25 to Atrial Fibrillation.
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阻塞性睡眠呼吸暂停和 4q25 染色体常见变异与心房颤动的关系。
DOI：
10.1016/j.amjcard.2017.01.038
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Monahan,Ken
中科院分区：
文献类型：
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作者：
Patel,NeelJ;Wells,QuinnS;Huang,Shi;Upender,RaghuP;Darbar,Dawood;Monahan,Ken
阻塞性睡眠呼吸暂停(OSA)和4q25基因的单核苷酸多态(SNPs)与房颤(AF)的风险增加相关。这些关联是否独立于房颤的传统危险因素仍不得而知。使用帐单代码查询和手动图表检查，我们收集了一组成年人，他们接受了夜间多导睡眠监测和至少1个12导联的心电图。病例状态由支持房颤的心电图数据或由专业心脏病专家记录的房颤来定义。对照的定义是缺乏房颤的主要证据和病历中没有房颤的诊断。根据呼吸暂停低通气指数对阻塞性睡眠呼吸暂停综合征的严重程度进行分类。使用Sequenom平台对关键的4q25 SNP(Rs2200733)进行基因分型。在调整年龄、性别、体重指数、血统、高血压状况和心力衰竭状况的同时，使用Logistic回归检验房颤与OSA分类和4q25 SNP基因型的相关性。队列包括674名受试者(62±13岁；44%为女性)，其中包括132名房颤患者。调整已建立的危险因素后，房颤与OSA严重程度之间的关联接近显著(优势比1.2，95%可信区间1.0至1.5)。在包括OSA严重程度的完全调整的模型中，房颤和4q25 SNP状态之间的关联仍然显著(优势比1.5，95%可信区间1.3至5.7)。综上所述，OSA严重程度和染色体4q25 SNP基因与房颤状态相关，与临床危险因素无关。对房颤相关SNPs的了解可能会提高多导睡眠监测者的房颤风险分层。
Obstructive sleep apnea (OSA) and single nucleotide polymorphisms (SNPs) at the 4q25 locus are associated with increased risk of atrial fibrillation (AF). Whether these associations are independent of traditional risk factors for AF remains unknown. Using billing code queries and manual chart review, we assembled a cohort of adults that underwent overnight polysomnography and at least 1 12-lead electrocardiogram. Case status was defined by electrocardiographic data in support of AF or documentation of AF by a staff cardiologist. Controls were defined by a lack of primary evidence of AF and absence of a diagnosis of AF in the medical record. OSA severity was categorized based on Apnea-Hypopnea Index. Genotyping for a key 4q25 SNP (rs2200733) was performed using the Sequenom platform. Logistic regression was used to test for associations of AF with OSA category and 4q25 SNP genotype while adjusting for age, gender, body mass index, ancestry, hypertension status, and heart failure status. The cohort consisted of 674 subjects (62 ± 13 years; 44% women), including 132 patients with AF. After adjustment for established risk factors, the association between AF and OSA severity was borderline significant (odds ratio 1.2, 95% CI 1.0 to 1.5). The association between AF and 4q25 SNP status remained significant in a fully adjusted model that included OSA severity (odds ratio 1.5, 95% CI 1.3 to 5.7). In conclusion, OSA severity and the chromosome 4q25 SNP genotype were associated with AF status independent of clinical risk factors. Knowledge of AF-related SNPs may enhance AF risk stratification for those undergoing polysomnography.