Effects of Nasal Septum Deviation and Septoplasty on Cardiac Arrhythmia Risk

Uluyol, Sinan; Kılıçaslan, Saffet; Gür, Mehmet; Karakaya, Nermin Erdas; Buber, Ipek; Ural, Sedef Gülçin

doi:10.1177/0194599816642432

Cited by 18 publications

(14 citation statements)

References 43 publications

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“…Nasal Septum Deviation: Preoperative PWD and QTcd values were significantly higher in nasal septum deviation patients than in the control group (Pd: 57.40 ± 14.21 vs 34.11 ± 7.12 milliseconds, P < 0.001 [37].…”

Section: Normal Limit Values Of P-wave Dispersion (Pwd)mentioning

confidence: 86%

“…Secondary pulmonary hypertension is included in the comorbidity criteria of CHF, a condition associated with PWD by heterogeneous atrial depolarization that predisposes to AF in COPD independent of lung function, blood gas and electrolyte levels, and atrial function [34]. Moderate/severe obstructive sleep apnea-hypopnea index ≥15 treated with nasa l continuous positive airway pressure: Three-month therapy significantly decreased PWD [35]. Respiratory maneuvers simulating Obstructive Sleep Apnea in healthy subjects and in patients with PAF: intrathoracic pressure swings PWD and therefore may represent an independent trigger factor for the development of PAF [36]. Nasal Septum Deviation: Preoperative PWD and QTcd values were significantly higher in nasal septum deviation patients than in the control group (Pd: 57.40 ± 14.21 vs 34.11 ± 7.12 milliseconds, P < 0.001 [37].…”

Section: Normal Limit Values Of P-wave Dispersion (Pwd)mentioning

confidence: 97%

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P-wave dispersion: an update

Pérez‐Riera

Abreu

Barbosa‐Barros

et al. 2016

Indian Pacing and Electrophysiology Journal

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P-wave dispersion (PWD, Pd or Pdis) is a noninvasive electrocardiographic (ECG) marker for atrial remodeling and predictor for atrial fibrillation (AF). PWD is defined as the difference between the widest and the narrowest P-wave duration recorded from the 12 ECG leads. Increased P-wave duration and PWD reflect prolongation of intraatrial and interatrial conduction time with lack of a well-coordinated conduction system within the atrial muscles, with inhomogeneous, asynchronic, pro-inflammatory and anti-inflammatory effect mediated by interleukin-6 (IL-6) in patients with the CG + GG genotype IL-6 -634C/G polymorphism [1] and discontinuous propagation of sinus impulses mainly between the left and right atria, interstitial/extracellular fibroblast activation and collagen deposition with fibrosis (via TGF-β) in atrial tissue, insufficient blood supply, significant not isotropic myoelectric activity, and thin wall thickness and consequent expansion tendency all well-known electrophysiological characteristics in patients with atrial arrhythmias and especially paroxysmal atrial fibrillation (PAF) [2].

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Section: Normal Limit Values Of P-wave Dispersion (Pwd)mentioning

confidence: 86%

Section: Normal Limit Values Of P-wave Dispersion (Pwd)mentioning

confidence: 97%

P-wave dispersion: an update

Pérez‐Riera

Abreu

Barbosa‐Barros

et al. 2016

Indian Pacing and Electrophysiology Journal

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“…Recent research on the subject has shown that upper respiratory tract obstruction causes chronic alveolar hypoxia and hypercapnia, leading to PHT and RV failure. Previous studies have also reported that RV functions recovered, and pulmonary artery pressure decreased significantly after surgical correction of upper airway obstruction in patients with adenotonsillar hypertrophy, NSD and similar pathologies [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ]. This study found a significant postoperative improvement in RV systolic functions at the tissue level in NSD patients.…”

Section: Discussionmentioning

confidence: 82%

“…Nasal septum deviation (NSD), is a frequent cause of nasal obstruction in adult patients. Other causes of upper airway obstruction include adenoid vegetation, tonsillar hypertrophy, nasal polyps, and nasal valve pathologies [ 1 , 2 , 3 , 4 , 5 , 6 , 7 ]. Obstruction in the upper respiratory tract reduces air flow, and causes chronic alveolar hypoxia and hypercapnia, leading to increased pulmonary vascular resistance, pulmonary hypertension (PHT), and eventually right ventricular (RV) failure [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Does Nasal Surgery Affect Right Ventricular Myocardial Functions at the Tissue Level in Patients with Nasal Septum Deviation?

Şimşek

2018

JCM

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Objective: One of the most common causes of upper airway obstruction in adults is nasal septum deviation (NSD). The chronic hypoxia caused by this obstruction gradually leads to increased pulmonary vascular resistance, pulmonary hypertension (PHT), and right ventricular (RV) failure. The purpose of this study was to determine changes in RV myocardial functions at the tissue level before, and after surgery in patients with NSD. Subjects and Methods: Fifty-eight patients with symptoms of nasal obstruction and snoring were included in this observational study. Preoperative and postoperative third-month peripheral arterial oxygen saturation (SpO2), and RV systolic and diastolic functions measured by pulmonary artery systolic pressure (PASP), tissue Doppler parameters, and speckle tracking echocardiography (STE) were studied in these patients. Results: We observed a very significant decrease in PASP in the postoperative period (32.54 ± 5.24 mmHg vs. 24.22 ± 4.55 mmHg, p = 0.001). Postoperative SpO2 values, measured at room temperature also increased significantly (93.5 ± 0.82% vs. 95.6 ± 0.79%, p = 0.001). There was a significant improvement after surgery in RV systolic functions, represented by global longitudinal strain (GLS) (21.12 ± 2.07 vs. 22.49 ± 1.89, p = 0.013) and systolic global longitudinal strain rate (GLSRs) (1.30 ± 0.12 vs. 1.38 ± 0.13, p = 0.015). No significant differences in terms of RV diastolic function parameters were detected, including the RV early diastolic global longitudinal strain rate (GLSRe) (1.56 ± 0.21 vs. 1.55 ± 0.26, p = 0.86) and RV late diastolic global longitudinal strain rate (GLSRa) (0.88 ± 0.19; 0.89 ± 0.18, p = 0.76). Conclusion: This study was performed with an advanced technique capable of tissue level examination. The findings demonstrated significant improvement in both chronic hypoxia and RV systolic myocardial functions, measured at the tissue level after nasal surgery.

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“…NSD is an expensive medical condition, and also acts as a predisposing factor for other diseases ( Bousquet et al, 2008 ; Fokkens et al, 2012 ). For instance, long-term NSD may indirectly increase the risk of cardiovascular disease ( Ozkececi et al, 2016 ; Uluyol et al, 2016 ). Conservative treatments for NSD have a low benefit likelihood ( Lindsay, 2012 ; Rhee et al, 2014 ; Rudy & Most, 2017 ), and according to studies published in The Lancet in 2019, nasal septoplasty is more effective than non-surgical treatment in adults with NSD ( Van Egmond et al., 2019 ).…”

Section: Introductionmentioning

confidence: 99%

A prediction modeling based on SNOT-22 score for endoscopic nasal septoplasty: a retrospective study

Kang

Chen

et al. 2020

PeerJ

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Background To create a nomogram prediction model for the efficacy of endoscopic nasal septoplasty, and the likelihood of patient benefiting from the operation. Methods A retrospective analysis of 155 patients with nasal septum deviation (NSD) was performed to develop a predictive model for the efficacy of endoscopic nasal septoplasty. Quality of life (QoL) data was collected before and after surgery using Sinonasal Outcome Test-22 (SNOT-22) scores to evaluate the surgical outcome. An effective surgical outcome was defined as a SNOT-22 score change ≥ 9 points after surgery. Multivariate logistic regression analysis was then used to establish a predictive model for the NSD treatment. The predictive quality and clinical utility of the predictive model were assessed by C-index, calibration plots, and decision curve analysis. Results The identified risk factors for inclusion in the predictive model were included. The model had a good predictive power, with a AUC of 0.920 in the training group and a C index of 0.911 in the overall sample. Decision curve analysis revealed that the prediction model had a good clinical applicability. Conclusions Our prediction model is efficient in predicting the efficacy of endoscopic surgery for NSD through evaluation of factors including: history of nasal surgery, preoperative SNOT-22 score, sinusitis, middle turbinate plasty, BMI, smoking, follow-up time, seasonal allergies, and advanced age. Therefore, it can be cost-effective for individualized preoperative assessment.

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Effects of Nasal Septum Deviation and Septoplasty on Cardiac Arrhythmia Risk

Abstract: In conclusion, NSD patients are at risk for both atrial and ventricular cardiac arrhythmias; however, septoplasty in these patients can relieve UAO and reduce the risk of arrhythmias.

Cited by 18 publications

References 43 publications

P-wave dispersion: an update

P-wave dispersion: an update

Does Nasal Surgery Affect Right Ventricular Myocardial Functions at the Tissue Level in Patients with Nasal Septum Deviation?

A prediction modeling based on SNOT-22 score for endoscopic nasal septoplasty: a retrospective study

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