高心血管疾病风险阻塞性睡眠呼吸暂停与发生性心房的关联:动脉样硬化多民族研究
Jing Xu1, Younghoon Kwon2, Neda Esmaeili3
1Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Respiratory and Critical Care Medicine, The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University, Huaian, Jiangsu, China.
Chest
|March 7, 2026
概括
具有高心血管风险的阻塞性睡眠呼吸暂停,定义为缺氧负担或心率反应,显著增加了心房动的风险. 这些指标可能有助于识别需要更密切监测AF的患者.
科学领域:
- 心脏病学 心脏病学
- 睡眠医学 睡眠医学
- 公共卫生 公共卫生
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 与心房动 (AF) 有关,但这种关联的强度各不相同.
- 使用心血管风险标志物的OSA严重程度的定义可能会改进AF的风险预测.
研究的目的:
- 根据缺氧负担 (HB) 或心率响应 (ΔHR),调查以高心血管疾病风险 (高CVD风险OSA) 为特征的OSA是否与事件AF相关.
- 为了确定HB或ΔHR是否可以预测OSA患者的AF.
主要方法:
- 利用了多民族动脉样硬化研究的数据,在患有OSA的参与者中量化HB和ΔHR (呼吸暂停-呼吸暂停指数≥15事件/小时).
- 定义为高心血管疾病风险的OSA,具有高HB或高ΔHR (顶部三角形).
- 使用Cox的比例危险模型来评估高CVD风险OSA,低CVD风险OSA和与非OSA相比的事件AF之间的关联.
主要成果:
- 在1679名参与者的队列中,高心血管疾病风险的OSA与非OSA相比,发生性AF的危险比率 (HR,1.68) 显著增加.
- 低心血管疾病风险的OSA没有显示出与事件AF (HR,1.20) 的统计学意义上的关联.
- 高心血管疾病风险OSA和AF之间的关联在男性和女性中是一致的.
结论:
- 在OSA患者中,较高的缺氧负担或心率激增可能作为发生性心房动的预测标志物.
- 这些特定的与OSA相关的生理反应可以帮助识别患有AF风险较高的个体.
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