Influence of sleep apnea on autonomic nervous activity and QT dispersion in patients with essential hypertension and old myocardial infarction

Yamashita, Jyunji; Nomura, Masahiro; Uehara, Kohzou; Nakaya, Yutaka; Uemura, Eiko; Iga, Akiko; Sawa, Yuko; Nishikado, Akiyoshi; Saito, Ken; Ito, Susumu

doi:10.1016/j.jelectrocard.2003.10.009

Cited by 15 publications

(8 citation statements)

References 29 publications

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“…Yamashita et al showed that QTd was significantly increased in old myocardial infarction and increased QTcd were observed in patients with hypertension with Sleep Atnea Syndrome (SAS) during episodes of apneas and hypopneas compared to those without SAS. 17 Lengthened QTd can be explained by the fact that these patients had myocardial infarction in their history which may prolong QT dispersion. 11,12 Hypertension could also affect these ECG parameters.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Sleep Apnea on QT Interval, QT Dispersion, and Arrhythmias

Barta

Szabó

Kun

et al. 2010

Clinical Cardiology

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Background: QT interval (QT) and QT dispersion (QTd) are electrocardiograph (ECG) parameters for the evaluation of myocardial repolarization. The inhomogeneity of ventricular repolarization is associated with ventricular arrhythmias. An increased QT, QTd, and increased incidence of nocturnal cardiac rhythm disturbances have been described in patients with obstructive sleep apnea (OSA), while other investigators did not find a relationship between ventricular arrhythmias and OSA. Hypothesis: The aim of this study was to examine the occurrence of ventricular arrhythmias and to measure QT parameters in patients with untreated OSA using an ambulatory Holter-ECG. Methods: A total of 25 patients with untreated OSA were studied. After routine biochemical investigation and 2-dimensional, M-mode echocardiography, a 24-hour Holter-ECG was recorded to detect cardiac arrhythmias and QT parameters. QT parameters were measured by the QT Guard system. Results: Only the QT interval increased significantly during the nighttime period (nocturnal QT interval: 423.1 ± 34.6 ms, daytime QT interval: 381.6 ± 33.8 ms, 24-hour QT interval: 394.7 ± 31.1 ms). However, during the nighttime QT interval (422.8 ± 14.9 ms), QTd (31.2 ± 11.0 ms) and QT dispersion (30.5 ± 10.2 ms) did not show any change compared to 24-hour (QTc interval: 423.7 ± 14.2 ms, QTd: 28.8 ± 9.4 ms, QTcd: 30.5 ± 9.43 ms) and daytime levels (QTc interval: 423.9 ± 14.3 ms, QTd: 27.3 ± 10.7 ms, QTcd: 29.9 ± 11.1 ms). None of the patients had ventricular arrhythmias. Conclusions: QTd and QTcd did not increase during the nighttime period. Our study did not show an increased risk of ventricular arrhythmias in this population during the monitoring period.

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Section: Discussionmentioning

confidence: 99%

The Effect of Sleep Apnea on QT Interval, QT Dispersion, and Arrhythmias

Barta

Szabó

Kun

et al. 2010

Clinical Cardiology

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“…One of the main causes of sleep disturbance is obstructive sleep apnea syndrome (OSAS). OSAS has been reported to raise the risk of cardiovascular system disorders and various other physical disorders 1, 2 . About 30–40% patients with OSAS complain of heartburn, and a high incidence of gastro‐oesophageal reflux disease (GERD) has been reported among patients suffering from OSAS 3 .…”

Section: Introductionmentioning

confidence: 99%

Gastric motility and autonomic activity during obstructive sleep apnea

Urata¹,

Fukuno²,

Nomura³

et al. 2006

Ali Pharm Thera Symp Ser

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Summary Background Patients with Obstructive Sleep Apnea Syndrome (OSAS) often experience gastroesophageal reflux disease (GERD). Aim To investigate gastric motility and autonomic nervous activity during sleep apnea. Methods The subjects of this study were 20 individuals with OSAS who experienced 10 or more sleep apnoea events per hour, as measured with a portable sleep polygraph. A percutaneous electrogastrography (EGG) and fast Fourier transformation analysis was carried out on the results. The mean amplitude was compared for bradygastria, normogastria and tachygastria. Spectral analysis of heart rate variability was performed, and low‐frequency (LF) power, high‐frequency (HF) power and the LF/HF ratio were measured. Oesophagogastroduodenal endoscopy was performed on each subject, and the presence of reflux oesophagitis (RE) was diagnosed according to the Los Angeles (LA) grade classification. Moreover, questionnaire for the diagnosis of reflux disease (QUEST) was carried out. Results Normogastria was significantly decreased, and brady‐, tachygastria, or both were increased during sleep apnea (P < 0.01). There was no significant relation between LA grade classification of RE and severity of OSAS. The LF/HF ratio was significantly higher during sleep apnea for patients with RE and OSAS, but the opposite for those with RE without OSAS. Decreased percutaneous arterial oxygen saturation and normogastria were independent risk factors for the severity of RE. Conclusions The present study suggested that, in addition to decreased pressure on the pleural cavity, factors affecting the development of RE might include abnormal gastric motility, low oxygen, and increased sympathetic nervous activity during sleep apnea.

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“…Apnoeic episodes, obstructive or central and often in connection with the sleep apnea syndrome, are linked with cardiac arrhythmias [45][46][47][48][49][50].…”

Section: Discussionmentioning

confidence: 99%

Light-dark dependence of electrocardiographic changes during asphyxia and reoxygenation in a rat model

et al. 2010

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AbstractThe aim of this study was to evaluate the effect of ventilation on electrocardiographic time intervals as a function of the light-dark (LD) cycle in an in vivo rat model. RR, PQ, QT and QTc intervals were measured in female Wistar rats anaesthetized with both ketamine and xylazine (100 mg/15 mg/kg, i.m., open chest experiments) after adaptation to the LD cycle (12:12h) for 4 weeks. Electrocardiograms (ECG) were recorded before surgical interventions; after tracheotomy, and thoracotomy, and 5 minutes of stabilization with artificial ventilation; 30, 60, 90 and 120 seconds after the onset of apnoea; and after 5, 10, 15, and 20 minutes of artificial reoxygenation. Time intervals in intact animals showed significant LD differences, except in the QT interval. The initial significant (p<0,001) LD differences in PQ interval and loss of dependence on LD cycle in the QT interval were preserved during short-term apnoea-induced asphyxia (30–60 sec) In contrast, long-term asphyxia (90–120 sec) eliminated LD dependence in the PQ interval, but significant LD differences were shown in the QT interval. Apnoea completely abolished LD differences in the RR interval. Reoxygenation restored the PQ and QT intervals to the pre-asphyxic LD differences, but with the RR intervals, the LD differences were eliminated. We have concluded that myocardial vulnerability is dependent on the LD cycle and on changes of pulmonary ventilation.

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Influence of sleep apnea on autonomic nervous activity and QT dispersion in patients with essential hypertension and old myocardial infarction

Cited by 15 publications

References 29 publications

The Effect of Sleep Apnea on QT Interval, QT Dispersion, and Arrhythmias

The Effect of Sleep Apnea on QT Interval, QT Dispersion, and Arrhythmias

Gastric motility and autonomic activity during obstructive sleep apnea

Light-dark dependence of electrocardiographic changes during asphyxia and reoxygenation in a rat model

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