QTc Dispersion, Cardiac Sympathetic Functionand Secretion of Leptin in Patients with Obstructive Sleep Apnea.

点击翻译按钮获取中文摘要

Hypoxemia increases corrected QT dispersion (QTcD), which is a strong risk factor for cardiovascular mortality. QTc dispersion during sleep in 48 consecutive OSAHS patients [mean age: 45.9, apnea & hypopnea index (AHI) :51.9/h, the percentage of time that arterial O2 saturation below 90% (SaO2<90%): 28.7%] during sleep decreased significantly after first night of nCPAP therapy (p<0.0001). Before tratment, the QTcD during sleep correlated with the AHI (p=0.009) and SaO2<90% time (p= ). The QTcD did not correlate with the washout rate of iodine-l23-metaiodobenzylguanidine (MIBG) cardiac imaging. Nocturnal QTcD is increased in OSAHS patients but is decreased by nCPAP therapy independently of cardiac sympathetic function.The first night of nCPAP treatment significantly decreased the plasma leptin levels (p<0.02) in 21 OSAHS patients with AHI 52.4/h. The magnitude of decreases in leptin levels in OSAHS patients after nCPAP treatment were significantly correlated with cardiac sympathetic fun … More ction as measured by MIBG scintigraphy before nCPAP treatment (p<0.03). Plasma leptin levels in OSAHS patients decreased significantly after the first night of nCPAP treatment. Enhanced cardiac sympathetic function in OSAHS patients may contribute to the leptin levels before nCPAP treatment and vice versa.In 40 obese men with OSAHS, AST and ALT levels were determined in the afternoon and the morning immediately after sleep, before and after nCPAP treatment. Aminotransferase levels were abnormal in 35% of patients. Before treatment, AST levels were higher in the morning than the previous afternoon (p=0.006). The increase in morning fasting AST and ALT levels improved with significance after the first night of nCPAP treatment (AST, P=0.0003; ALT, p=0.006) Improvement of AST and ALT levels was maintained after 1 and 6 months of nCPAP treatment. OSAHS had significant effects on liver function. nCPAP therapy should be considered as a new strategy for patients with obesity and aminotransferase abnormalities who have obstructive sleep apnea. Less