Obstructive Sleep Apnoea Impairs Heart Rate Variability in Patients with the Metabolic Syndrome

2007 ◽  
Vol 16 ◽  
pp. S84
Author(s):  
B. Weatherhead ◽  
C. Neil ◽  
M. Barnes ◽  
R. Pierce ◽  
A. Collins ◽  
...  
2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A52-A52
Author(s):  
A Mohammadieh ◽  
H Dissanayake ◽  
K Sutherland ◽  
S Ucak ◽  
P de Chazal ◽  
...  

Abstract Introduction Physiological studies have demonstrated the importance of the autonomic nervous system in mediating acute apnoea-induced atrial fibrillation (AF). We aimed to compare Heart Rate Variability (HRV) markers of autonomic function in paroxysmal atrial fibrillation (PAF) patients with and without obstructive sleep apnoea (OSA). A secondary aim was the analysis of ectopic beats in these groups. Methods Nocturnal ECG traces from 89 PAF patients who underwent in-laboratory polysomnography were included. After identifying ectopic beats in the ECGs, periods of arrhythmia as well as sleep apnoea events were excluded. HRV time and frequency domains were reported by sleep stage (REM vs Non-REM) for patients with and without OSA. Results Frequency domain analysis of HRV during non-REM sleep in PAF patients with OSA showed increased cardiac parasympathetic modulation (HF-nu: 39.13 ± 15.74 vs 47.98 ± 14.60, p = 0.008*) and reduced cardiac sympathetic modulation (LF/HF ratio: 2.05 ± 2.02 vs 1.17 ± 0.98, p = 0.007*). Results remained significant after adjusting for age, sex and BMI (adjusted p values 0.024 and 0.018 respectively). PAF patients with severe OSA (AHI ≥ 30/hr) had more AF beats and Ventricular Ectopic Beats than those without severe OSA (22.7 ± 42.8% vs 3.7 ± 17.9%, p = 0.006*, 1.7 ± 3.8 vs 0.3 ± 0.9%, p = 0.004* respectively). Conclusions This is the first study of HRV in AF patients with and without OSA. It suggests a chronic increase in parasympathetic nervous modulation and relative reduction in sympathetic modulation in PAF patients with OSA.


2010 ◽  
Vol 9 (1) ◽  
pp. 12 ◽  
Author(s):  
Lise Tarnow ◽  
Brigitte Klinkenbijl ◽  
Holger Woehrle ◽  
◽  
◽  
...  

Obstructive sleep apnoea (OSA) is a significant health issue. Patients with cardiovascular disease as well as patients with diabetes have a high prevalence of OSA, and the prevalence of coronary heart disease, heart failure, stroke and diabetes is increased in patients with obstructive sleep apnoea. Physiological responses to OSA include sympathetic activation, neurohumoral changes and inflammation, all of which are precursors for cardiovascular disease and diabetes. International guidelines are starting to recognise the importance of OSA for patients with cardiovascular conditions such as heart failure and hypertension. Diagnosis is important, and home-based sleep testing devices can facilitate this process. Treating OSA with continuous positive airway pressure (CPAP) has been shown to reduce blood pressure (BP) in patients with hypertension, but more research is needed to determine which components of the metabolic syndrome respond best to the addition of CPAP therapy.


Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Ivani C Trombetta ◽  
Cristiane M Nunes ◽  
Luciano F Drager ◽  
Raffael F Fraga ◽  
Maria Janieire N Alves ◽  
...  

Obstructive sleep apnoea (OSA) and metabolic syndrome (MetS) independently increases muscular sympathetic nervous activity (MSNA). Unknown is whether OSA has an additive effect on MSNA in patients with MetS. We tested the hypothesis that: OSA would have an additive effect on MSNA in patients with MetS. In addition, we studied whether the increase in MSNA in patients with MetS is associated with alteration in arterial baroreflex sensitivity (BRS). Twenty four patients with MetS diagnosed according ATP-III were divided in two groups: MetS+OSA (n=14) and MetS (n=10). They were matched for age, body mass index, waist circumference, and metabolic profile: OSA was defined by an apnoea/hypopnoea index (AHI)>15 events/hour by polysonography. MSNA was recorded directly from the peroneal nerve using the technique of microneurography. Blood pressure (BP) was monitored on a beat-by-beat basis (Finapress) and heart rate by ECG. BRS was analyzed by spontaneous BP and heart rate fluctuations. AHI was higher (42±9 vs. 7±1 events/h, P =0.0001) and minimum oxygen saturation lower (77±2 vs. 87±1 %, P =0.001) in MetS+OSA patients. Patients MetS+OSA had higher MSNA (55±3 vs. 43±2 bursts/100 beats, P =0.01) and systolic BP (158±4 vs.144±3 mmHg, P =0.01) when compared with patients with MetS without OSA. Further analysis showed that AHI and minimum oxygen saturation have significant correlation with MSNA (r=0.65; P =0.001 and r=−0.48; P =0.017, respectively). Patients with MetS+OSA had lower BRS for increases (7.8±0.9 vs. 13.4 ± 1.4 msec/mmHg, P =0.01) and decreases (7.2±0.9 vs. 13.2 ± 2.0 msec/mmHg, P =0.03) in blood pressure than patients with MetS without OSA. MSNA significantly correlated with BRS during spontaneous increases in blood pressure (r=−0.56, P =0.01). OSA exacerbates MSNA in patients with MetS. In addition, the augmented MSNA in patients with MetS+OSA is associated with reduced BRS. These findings suggest that OSA increases the risk for cardiovascular disease in patients with MetS.


2020 ◽  
Vol 12 (S2) ◽  
pp. S129-S138
Author(s):  
Matteo Bradicich ◽  
Noriane A. Sievi ◽  
Fabian A. Grewe ◽  
Alessio Gasperetti ◽  
Malcolm Kohler ◽  
...  

2010 ◽  
Vol 21 (3) ◽  
pp. 191-195 ◽  
Author(s):  
Francesco Angelico ◽  
Maria del Ben ◽  
Teresa Augelletti ◽  
Rosanna de Vita ◽  
Rocco Roma ◽  
...  

2018 ◽  
Vol 5 (6) ◽  
pp. 1476
Author(s):  
Bhavesh R. Sureja ◽  
Gaurav D. Bhambhani

Background: The interaction of obstructive sleep apnoea (OSA) with vascular risk factors is known as syndrome Z which is also known as the metabolic syndrome or the insulin resistance syndrome and these include the hypertension, central obesity, insulin resistance and hyperlipidaemia. The objective of the present study was to investigate the prevalence and severity of syndrome Z at tertiary care center.Methods: This prospective study was conducted among 40 eligible patients between May and July 2018 at the tertiary care center included adult patients >18years of age. Overnight fasting glucose and lipid levels were measured, and baseline anthropometric data recorded. All sleep studies were scored and reported by a sleep physician. OSA was deemed to be present if the respiratory disturbance index (RDI) was >5, with mild, moderate and severe categories classified according to the Chicago criteria.Results: Mean age of participants was 52.7years, 77.5% were male, Mean BMI and waist circumference were 29.2kg/m2 and 113.8cm respectively. Almost 92.5% participants were known case of HTN, 85.0% were DM and 67.5% Dyslipidemia. Around 60.0% participants were belonged to severe grade of OSAS and 7 (17.5%) patients who fulfilled all five criteria for the diagnosis of the metabolic syndrome had severe OSAS. The prevalence of OSA in the entire group was 95.0%.Conclusions: The prevalence of syndrome Z in present study participants was very high. With the help of history and polysomnogram, metabolic syndrome should be screened for OSA. Early diagnosis and treatment of OSA is the essential part in the treatment of metabolic syndrome and hence CAD.


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