Obstructive Sleep Apnea as a Predictor of Abnormal Heart Rate Turbulence

Abstract

Obstructive sleep apnea (OSA) causes dysfunction of the autonomic nervous system, but the exact mechanism has not been fully understood. The aim of this study was to analyse the relationship between the incidence and severity of OSA and heart rate turbulence (HRT). Seventy one patients with clinical suspicion of OSA were qualified to participate in the study. All participants took part in a survey and were subjected to laboratory tests, 24-hour electrocardiogram (ECG) Holter monitoring with HRT analysis and polysomnography. The group with OSA manifested significantly higher turbulence onset (TO) and lower turbulence slope (TS) as compared to the group without OSA. Older age, diabetes, hypertension and higher apnea/hypopnea index (AHI) were found to be independent risk factors for increased TO, whereas older age, higher body mass index (BMI), higher blood glucose levels, hypertension and higher AHI were independent risk factors for TS reduction. The AHI ≥65 criterion indicates abnormal HRT in patients with OSA with 94.9% sensitivity and 50.0% specificity, which gives a prediction accuracy of 85.7%. In summary, OSA should be considered as a predictor of abnormal HRT.

Heart Rate Turbulence Predicts Survival Independently From Severity of Liver Dysfunction in Patients With Cirrhosis

“…The use of physiological biomarkers (physio-markers) for clinical assessment and prognosis in patients with chronic liver disease has been a topic of interest in the recent years ( Fleisher et al, 2000 ; Coelho et al, 2001 ; Ates et al, 2006 ; Newton et al, 2006 ; Mani et al, 2009 ; Abrahamovych et al, 2017 ; Chan et al, 2017 ; Jansen et al, 2018 , 2019 ; Bhogal et al, 2019 ; Satti et al, 2019 ). Much interest has been shown lately especially in the use of indices of HRV as a prognostic tool in various diseases ( de Lima et al, 2015 ; Poliwczak et al, 2019 ; Urbanik et al, 2019 ; Braunisch et al, 2020 ; Yalim et al, 2020 ; Yamada et al, 2020 ). This is due to the ease of use and non-invasive nature of these method.…”

Depression with obstructive sleep apnea lead to high cardiovascular disease morbidity/all‐cause mortality: Findings from the SHHS cohort

“…Previous studies have suggested that depression was significantly associated with an increased risk of CVD due to similar risk factors (Ivanovs et al, 2018; Nicholson et al, 2006). Moreover, OSA may contribute to intermittent hypoxia and frequent micro‐arousals, leading to an increase in the risk of CVD (Urbanik et al, 2019). Nevertheless, the risk of CVD and mortality in patients with depression with OSA (DOSA) remains unknown.…”

Table_6.DOCX

“…The use of physiological biomarkers (physio-markers) for clinical assessment and prognosis in patients with chronic liver disease has been a topic of interest in the recent years (Fleisher et al, 2000;Coelho et al, 2001;Ates et al, 2006;Newton et al, 2006;Mani et al, 2009;Abrahamovych et al, 2017;Chan et al, 2017;Jansen et al, 2018Jansen et al, , 2019Bhogal et al, 2019;Satti et al, 2019). Much interest has been shown lately especially in the use of indices of HRV as a prognostic tool in various diseases (de Lima et al, 2015;Poliwczak et al, 2019;Urbanik et al, 2019;Braunisch et al, 2020;Yalim et al, 2020;Yamada et al, 2020). This is due to the ease of use and non-invasive nature of these method.…”