心脏自主功能障碍和结构重塑:潜在的机制来调解阻塞性睡眠呼吸暂停和心律失常之间的关系
Hao Chen1, Qingfeng Zhang1, Yueying Hao1
1Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, China.
Frontiers in medicine
|April 17, 2024
概括
阻塞性睡眠呼吸暂停 (OSA) 显著增加了心律不整的风险,如心房动 (AF) 和非持续性心室动脉冲动 (NSVT). 这些风险与自主功能障碍和由OSA引起的心脏结构变化有关.
科学领域:
- 心脏病学 心脏病学
- 睡眠医学 睡眠医学
- 自主神经系统的自主神经系统
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 经常与心律不整有关,特别是心房动 (AF) 和非持续性心室性心力衰竭 (NSVT).
- OSA可能导致心脏自主功能障碍和结构重塑,创造有利于心律失常发展的条件.
研究的目的:
- 确定阻塞性睡眠呼吸暂停 (OSA) 和各种心律失常之间的关联.
- 为了研究将OSA与心律失常联系起来的病理生理路径.
主要方法:
- 对600名疑似OSA患者的分析,这些患者接受了睡眠监测,实验室测试,霍尔特心电图和心声回声.
- 在患有和没有OSA的患者之间比较心律不整的患病率,调整为混因素.
主要成果:
- 中度OSA显示AF的几率增加了3倍 (OR3.055,p=0.048).
- 严重的OSA表明AF (OR 3.881,p=0.015) 和NSVT (OR 3.690,p=0.046) 的几率增加了3倍.
- OSA的严重程度与AF和NSVT线性相关,由心脏结构变化和自主神经系统变化 (LF/HF比率) 介导.
结论:
- 严重的OSA是AF和NSVT的独立风险因素.
- 自主神经系统的变化和心脏结构重塑调解了OSA和心律失常之间的联系.
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