Association of nocturnal arrhythmias with sleep-disordered breathing - The Sleep Heart Health Study
Association of nocturnal arrhythmias with sleep-disordered breathing - The Sleep Heart Health Study
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DOI：
10.1164/rccm.200509-1442oc
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发表时间：
2006-04-15
影响因子：
24.7
通讯作者：
Redline, S
中科院分区：
文献类型：
--
作者：
Mehra, R;Benjamin, EJ;Redline, S
目的：我们假设有睡眠呼吸障碍的受试者夜间心律失常的发生率高于没有睡眠呼吸障碍的受试者。方法：比较两组在年龄、性别、种族和体重指数上频率匹配的受试者的心律失常发生率：(1)228名有睡眠呼吸障碍的受试者(呼吸紊乱指数=30)和(2)338名没有睡眠呼吸紊乱的受试者(呼吸紊乱指数和体重指数)。5).结果：与无睡眠呼吸障碍的受试者相比，有睡眠呼吸障碍的受试者更常见房颤、非持续性室性心动过速和复杂室性异位(非持续性室性心动过速或二联性或三联性或四联性)：房颤者为4.8%(p=0.003)；非持续性室性心动过速为5.3%(p=0.004)；复杂室性异位症为25.0%(p=0.002)。与没有睡眠呼吸障碍并调整了年龄、性别、体重指数和流行的冠心病的人相比，睡眠呼吸障碍患者发生房颤的几率是对照组的4倍(优势比[OR]，4.02；95%可信区间[CI]，1.03-15.74)，发生非持续性室性心动过速的几率是非持续性室性心动过速(OR，3.40；95%CI，1.03-11.20)的3倍，复杂室性异位的几率几乎是后者的两倍(OR，1.74；95%CI，1.11-2.74)。睡眠障碍呼吸与室性异位搏动/小时(p<；0.0003)之间也有显著的相关性，被认为是一个连续的结果。结论：即使在对潜在混杂因素进行调整后，有严重睡眠障碍呼吸的个体发生复杂心律失常的几率也比没有睡眠障碍呼吸的个体高两到四倍。
Rationale: Sleep-disordered breathing recurrent intermittent hypoxia and sympathetic nervous system activity surges provide the milieu for cardiac arrhythmia development.Objective: We postulate that the prevalence of nocturnal cardiac arrhythmias is higher among subjects with than without sleep-disordered breathing.Methods: The prevalence of arrhythmias was compared in two samples of participants from the Sleep Heart Health Study frequency-matched on age, sex, race/ethnicity, and body mass index: (1) 228 subjects with sleep-disordered breathing (respiratory disturbance index >= 30) and (2) 338 subjects without sleep-disordered breathing (respiratory disturbance index < 5).Results: Atrial fibrillation, nonsustained ventricular tachycardia, and complex ventricular ectopy (nonsustained ventricular tachycardia or bigeminy or trigeminy or quadrigeminy) were more common in subjects with sleep-disordered breathing compared with those without sleep-disordered breathing: 4.8 versus 0.9% (p = 0.003) for atrial fibrillation; 5.3 versus 1.2% (p = 0.004) for nonsustained ventricular tachycardia; 25.0 versus 14.5% (p = 0.002) for complex ventricular ectopy. Compared with those without sleep-disordered breathing and adjusting for age, sex, body mass index, and prevalent coronary heart disease, individuals with sleep-disordered breathing had four times the odds of atrial fibrillation (odds ratio [OR], 4.02; 95% confidence interval [CI], 1.03-15.74), three times the odds of nonsustained ventricular tachycardia (OR, 3.40; 95% CI, 1.03-11.20), and almost twice the odds of complex ventricular ectopy (OR, 1.74; 95% CI, 1.11-2.74). A significant relation was also observed between sleep-disordered breathing and ventricular ectopic beats/h (p < 0.0003) considered as a continuous outcome.Conclusions: Individuals with severe sleep-disordered breathing have two- to fourfold higher odds of complex arrhythmias than those without sleep-disordered breathing even after adjustment for potential confounders.