QT dispersion in childhood obstructive sleep apnoea syndrome

Khositseth, Anant; Nantarakchaikul, Palinee; Kuptanon, Teeradej; Preutthipan, Aroonwan

doi:10.1017/s1047951110001514

Cited by 15 publications

(16 citation statements)

References 19 publications

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“…Several studies in children have previously demonstrated an association between increased resting QTd and various conditions. Although most studies demonstrated an association with arrhythmia [8,11,36], QTd was also reported in conditions without arrhythmia, such as acute rheumatic carditis [10], obesity [29], sleep apnea [21], and type 1 diabetes [34]. The absence of CA disease in these pediatric reports corroborate with our findings.…”

Section: Discussionsupporting

confidence: 90%

Ventricular Repolarisation During Exercise Challenge Occurring Late After Kawasaki Disease

et al. 2012

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Exercise testing can highlight repolarisation abnormalities in adults with coronary artery disease. Late after Kawasaki disease (KD), increased QT dispersion (QTd) has been reported on resting ECG in children, but there are no reported studies of QTd during exercise. Our objective was to determine the pattern of QTd response to exercise testing in children late after KD. Twenty-five KD patients without coronary complications, 28 with coronary dilation, and 18 with severe complications were compared with 28 controls. KD patients were 11.6 ± 3.0 years old versus 12.8 ± 2.9 for controls [p = not significant (NS)], and these patients were studied 7.5 ± 3.4 years after the onset of the disease. QT was measured from the onset of QRS to the apex (QTa) and the end (QTe) of T wave. Resting QTd was significantly increased in KD subjects (p < 0.05). The proportion of abnormal QTd was evenly distributed across the three KD groups (29-36%; p = NS). QTd response to exercise was significantly altered in KD, irrespective of resting QTd or coronary sequelae. Abnormal resting- and exercise-induced repolarisation are detectible after KD irrespective of the severity of coronary sequelae.

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Section: Discussionsupporting

confidence: 90%

Ventricular Repolarisation During Exercise Challenge Occurring Late After Kawasaki Disease

et al. 2012

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“…On the other hand, documented data for the relation of respiratory disorders and cardiovascular diseases related to sleep also indicate the arrhythmogenic properties of the sleep related respiratory diseases. In the current study done by Khositseth et al (11) QT dispersion and corrected QT dispersion values were higher in children with OSAS compared to normal population. As known in general, QT dispersion points to arrhythmogenic potential (12).…”

Section: Discussionsupporting

confidence: 44%

“…Apneic bradycardia and postvagal tachycardia that occurs later on compose the occult additional diagnostic findings that was on the telemetric ECG recordings (28). Upon the increase of the knowledge on the analysis of ECG data using different analytic methods could be helpful in recognizing of the sleep related respiratory disturbances, recent studies investigating the availability of ECG in OSAS screening have focused on the analysis of the different segments of ECG such as QT dispersion and the contribution of various algorithms to the diagnosis (11). Current studies for the OSAS survey evaluating different algorithms and data from these algorithms from the spectral analysis of one channel ECG due exist.…”

Section: Discussionmentioning

confidence: 99%

Heart rate variability analysis of single channel electrocardiogram can help to differentiate high- risk patients with obstructive sleep apnea syndrome - a study on diagnostic accuracy

Karasulu¹,

Dalar²,

Sökücü³

et al. 2012

Anadolu Kardiyol Derg

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Heart rate variability analysis of single-channel electrocardiogram can help to differentiate high-risk patients with obstructive sleep apnea syndrome -a study on diagnostic accuracyTek kanal elektrokardiyografide kalp hızı değişkenliği analizi yüksek riskli obstrüktif uyku apne sendromlu hastaları tanımlamada yardımcı olabilir-Bir doğruluk değeri çalışması ABSTRACTObjective: To evaluate the usefulness of heart rate variability analysis (HRV) analysis from the long duration electrocardiogram (ECG) recordings as a screening test for the diagnosis of moderate-to-severe obstructive sleep apnea syndrome (OSAS). Methods: Recordings from 87 patients who were admitted to sleep laboratory for polysomnographic study (PSG) were evaluated. Finally 30 cases with apnea-hypopnea index (AHI)≥15/hour included in patient's group (male/female: 22/8; mean age: 49±10 years) and 21 cases with AHI<5 were included in control group (male/female: 10/11; mean age: 48±11 years). From the ECG recordings taken as a part of PSG, time -domain and frequency -domain HRV parameters were evaluated and their accuracy in the diagnosis of OSAS was investigated using ROC analysis.Results: Statistically significant differences were found in HRV variables in time-domain parameters such as SDNN, SDNN index; frequencydomain parameters VLF, LF, nuLF, nuHF, LF/HF and geometric parameter HRV triangular index values in between groups. Cut-off value of 16 for the HRV triangular index was found to be 50% sensitive and 85.7% specific with a positive likelihood ratio (LR) of 3.50% and negative LR of 0.58% When the total power was higher than 9.611, then the analysis sensitivity was 53.3%, specificity was 95.6%, positive LR was 11.2% and negative LR was 0.49% When the SDNN was higher than 83 then its sensitivity was 80%, specificity was 76.2%, positive LR was 3.36% and negative LR was 0.26% For the cut off value of 62 calculated for SDNN index, sensitivity was 73.3%, specificity was 85.7%, positive LR was 5.13% and negative LR was 0.31%, for the cut off value of 9.12 was calculated for VLF, sensitivity was 90.4% specificity was 50% positive LR was 1.81% and negative LR was 0.19%. Conclusion: Heart rate variability analysis done over routine single channel ECG data gathered through routine Holter applications may be helpful in distinguishing moderate-to-severe OSAS patients from mild OSAS patients and non-OSAS control subjects.(Anadolu Kardiyol Derg 2012; 12: 331-8) Key words: Diagnosis, electrocardiography, heart rate, polysomnography, sleep apnea, sensitivity, specificity Original Investigation Özgün Araşt›rma 331ÖZET Amaç: Çalışmanın amacı uzun süreli tek kanal elektrokardiyogram (EKG) kaydı üzerinden yapılan kalp atım hızı değişkenliği (HRV) analizinin orta ve ağır tıkayıcı uyku apne hipopne sendromu (TUA) hastalarının taranmasına katkısını araştırmaktır.Yöntemler: Hastanemizin uyku laboratuvarına başvurarak polisomnografi yapılan 87 hastanın kayıtları değerlendirildi. Değerlendirme sonucunda apne-hipopne indeksi (AHI)≥15/saatin üzerinde bulunan 30 kişi olgu ...

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“…QTd is another marker of cardiac repolarization abnormality and risk of SCD. Several recent studies have reported increased QTd in adults and children with OSA [35,50]. Therefore, measurements of QTd in OSA patients might identify the risk of arrhythmias in these patients.…”

Section: Discussionmentioning

confidence: 99%

Daytime cardiac repolarization in patients with obstructive sleep apnea

et al. 2015

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Purpose Obstructive sleep apnea (OSA) has been implicated in complications of cardiovascular disease, including arrhythmias and sudden cardiac death (SCD). Prolonged QT interval is associated with arrhythmias and SCD in patients with cardiovascular disease and apparently healthy humans. Apneic episodes during sleep in OSA patients are associated with QT prolongation due to increased vagal activity, but it is not understood whether chronic QT prolongation persists during normoxic daytime wakefulness. Methods To determine whether daytime QT intervals in OSA patients are prolonged compared to control subjects, we recruited 97 (76 male, 21 female) newly diagnosed patients with OSA [apnea-hypopnea index (AHI) ≥5 events/h] and 168 (100 male, 68 female) healthy volunteers (AHI <5 events/h) and measured daytime resting QT and RR intervals from the electrocardiograms to determine QT prolongation corrected for heart rate (QTc). Results All subjects with OSA were older and heavier, with increased heart rate and significantly increased AHI, arousal index, and reduced oxygen saturation (SpO2) during sleep, and spent less time in sleep with >90% SpO2 compared to respective controls. QTc in patients with OSA (410±3.3 for male and 433±5.6 for female) was significantly increased compared to respective control groups (399±2.9 for male and 417±2.9 for female), after adjustment for age and body mass index. Conclusions Our data show that OSA in either men or women is associated with a significant increase in resting daytime QTc. The propensity for ventricular arrhythmias in patients with OSA may be a result of abnormalities in resting cardiac repolarization.

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QT dispersion in childhood obstructive sleep apnoea syndrome

Cited by 15 publications

References 19 publications

Ventricular Repolarisation During Exercise Challenge Occurring Late After Kawasaki Disease

Ventricular Repolarisation During Exercise Challenge Occurring Late After Kawasaki Disease

Heart rate variability analysis of single channel electrocardiogram can help to differentiate high- risk patients with obstructive sleep apnea syndrome - a study on diagnostic accuracy

Daytime cardiac repolarization in patients with obstructive sleep apnea

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