Sleep‐disordered breathing and electrocardiographic <scp>QRS</scp>‐T angle: The <scp>MESA</scp> study

Kwon, Younghoon; Misialek, Jeffrey R.; Duprez, Daniel; Jacobs, David R.; Alonso, Álvaro; Heckbert, Susan R.; Zhao, Ying; Redline, Susan; Soliman, Elsayed Z.

doi:10.1111/anec.12579

Cited by 7 publications

(8 citation statements)

References 32 publications

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“…Similarly, Shamsuzzaman et al demonstrated that OSA is associated with a significant increase in resting daytime QTc based on continuous 10-minute supine resting ECG [8]. OSA has also been associated with a higher prevalence of other ECG findings representing high-risk features for ventricular arrhythmia such as QT dispersion, Tp-e interval, Tp-e/QT ratio, and QRS-T angle [16][17][18].…”

Section: Discussionmentioning

confidence: 93%

Daytime QT by Routine 12-Lead ECG Is Prolonged in Patients with Severe Obstructive Sleep Apnea

et al. 2020

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Background. Obstructive sleep apnea (OSA) has been linked to sudden cardiac death (SCD). Prolonged QT is a recognized electrocardiographic (ECG) marker of abnormal ventricular repolarization linked to increased risk of SCD. We hypothesized that individuals with OSA have more pronounced abnormality in daytime QT interval. Methods. We reviewed consecutive patients who underwent clinically indicated polysomnography with 12-lead ECG within 1 year at a single center. Heart rate-corrected QT interval (QTc) was compared by OSA severity class (normal/mild: apnea‐hypopnea index AHI<15/hr (n=72); moderate: 15-30 (n=72); severe: >30 (n=105)) adjusting for body mass index, age, sex, hypertension, and heart failure. Further evaluation was performed by dividing patients into severe (AHI>30) and nonsevere (<30) OSA. Logistic analysis was used to determine association of OSA severity and abnormal QTc (>450/>470 ms for men/women, respectively). Results. A total of 249 patients were included. QTc was similar between the normal/mild and moderate groups, and the overall QTc trend increased across OSA (normal/mild: 435.6 ms; moderate: 431.36; severe: 444.4; p trend=0.03). Abnormal QTc was found amongst 34% of male and 31% of female patients. Patients with severe OSA had longer QTc compared with normal/mild OSA (mean difference (95% CI): 10.0 ms (0.5, 19.0), p=0.04). When stratified dichotomously (as opposed to three groups), patients with severe OSA again had longer QTc (vs. nonsevere OSA) (444.4 ms vs. 433.48 ms, p=0.004). Severe OSA was also associated with abnormal QTc (OR (95% CI): 2.68 (1.34, 5.48), p=0.006). Conclusions. In a sleep clinic cohort, severe OSA was associated with higher QTc and clinically defined abnormal QTc compared with nonsevere OSA.

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Section: Discussionmentioning

confidence: 93%

Daytime QT by Routine 12-Lead ECG Is Prolonged in Patients with Severe Obstructive Sleep Apnea

et al. 2020

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“…One mechanism that would explain the link is the influence of OSA on ventricular depolarization and repolarization. Patients with OSA more commonly exhibit high risk electrocardiographic markers such as prolonged QT, T peak to T end (TpTe) interval and high QRS-T angle, all of which confer high risk for malignant arrhythmias [32][33][34]. Although the role of OSA in SCD needs further elucidation, we speculate that OSA possibly increases the risk of SCD via increasing risks for other CVD such as coronary heart disease.…”

Section: Sleep Apnea and Sudden Cardiac Deathmentioning

confidence: 90%

Sleep Apnea and Heart

et al. 2019

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Scientific investigations in the past few decades have supported the important role of sleep in various domains of health. Sleep apnea is a highly prevalent yet underdiagnosed sleep disorder representing a valid cardiovascular risk factor, particularly for hypertension. While several studies have demonstrated the benefits of sleep apnea treatment on subclinical cardiovascular measures, there is a paucity of studies proving reduction of cardiovascular events and mortality. Sufficient and highquality sleep is also important in the maintenance of cardiovascular health. Future investigations should focus on improving identification of patients at greatest risk of adverse cardiovascular sequelae of sleep apnea and testing the therapeutic benefit of sleep apnea treatment in this vulnerable group.

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“…В мультиэтнической популяционной когорте увеличение как пространственного, так и фронтального угла QRS-T связано с более высоким индексом апноэ-гипопноэ (Y. Kwon и соавт., 2018) [38].…”

Section: ìåõàíèçìû óâåëè÷åíèÿ óãëà Qrs-tunclassified

Diagnostic and prognostic significance of QRS-T angle

Blinova

Sakhnova

Yurasova

2020

Terapevticheskii arkhiv

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The angle between theQRSandTvectors reflects the consistency or inconsistency of the processes of de- and repolarization of the ventricles of the heart and is considered one of the indicators of global electrical heterogeneity of myocardium. In recent years, the prognostic value of theQRS-Tangle has been demonstrated in relation to total and cardiovascular mortality, both in the population and in various groups of patients. The mechanisms of this phenomenon are not completely clear. The review analyses studies published over the past five years on the relationship between theQRS-Tangle and mortality, as well as coronary heart disease and heart failure. Possible mechanisms for increasing theQRS-Tangle are discussed. Data are given on the use of theQRS-Tangle in diagnostic and prognostic scales, including in combination with other indicators of global electrical heterogeneity of myocardium.

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Sleep‐disordered breathing and electrocardiographic QRS‐T angle: The MESA study

Abstract: In a racially/ethnically diverse community cohort, severity of SDB is associated with abnormal ventricular repolarization as measured by QRS-T angle.

Cited by 7 publications

References 32 publications

Daytime QT by Routine 12-Lead ECG Is Prolonged in Patients with Severe Obstructive Sleep Apnea

Daytime QT by Routine 12-Lead ECG Is Prolonged in Patients with Severe Obstructive Sleep Apnea

Sleep Apnea and Heart

Diagnostic and prognostic significance of QRS-T angle

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