阻塞性睡眠呼吸暂停导致的间歇性缺氧与心房颤动患者左心房结构重塑之前的电解剖重塑密切相关

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature Pub Date : 2024-08-13 DOI:10.1016/j.ijcha.2024.101490

Yasuyuki Takada , Kazuki Shiina , Shunichiro Orihara , Yoshifumi Takata , Takamichi Takahashi , Junya Kani , Takahiro Kusume , Muryo Terasawa , Hiroki Nakano , Yukio Saitoh , Yoshinao Yazaki , Hirofumi Tomiyama , Taishiro Chikamori , Kazuhiro Satomi

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引用次数: 0

摘要

背景阻塞性睡眠呼吸暂停（OSA）是心房颤动（AF）的危险因素之一。本研究对 83 例因房颤接受导管消融术的患者（49 例伴有 OSA，34 例对照组无 OSA）进行了研究。所有患者的左心房（LA）图都是通过三维电子解剖图绘制系统绘制的。双极电压为 0.5 mV 的 LA 被定义为低电压区（LVA）；LVA% 被定义为 LVA 与 LA 总表面积之比。3% 氧饱和度指数 (ODI) 与 LVA 百分比显著相关（r = 0.268，P = 0.014），但与 LA 面积无关。结论在房颤并发 OSA 的患者中，观察到 LVA 显著增加，但 LA 面积没有增加。间歇性缺氧的严重程度与 LVA 显著相关。这些结果表明，OSA 引起的间歇性缺氧可能是房颤患者 LA 电解剖重塑的机制之一，可能先于 LA 扩大所代表的结构重塑。

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Intermittent hypoxia by obstructive sleep apnea is significantly associated with electro-anatomical remodeling of the left atrium preceding structural remodeling in patients with atrial fibrillation

Background

Obstructive sleep apnea (OSA) is one of the risk factors for atrial fibrillation (AF). However, the mechanism underlying the atrial structural and electro-anatomical remodeling by OSA has not yet been clearly elucidated.

Methods

This study was conducted in 83 patients who had undergone catheter ablation for AF (49 with OSA and 34 Controls without OSA). The left atrial (LA) maps were created in all the patients using a three-dimensional electro-anatomical mapping system. The LA with a bipolar voltage of <0.5 mV was defined as the low voltage area (LVA); %LVA was defined as the ratio of the LVA to the total surface area of the LA.

Results

The LVA and %LVA were significantly greater in the OSA group as compared with the Control group, however, there was no difference in the LA area. The 3 % oxygen desaturation index (ODI) was significantly correlated with the %LVA (r = 0.268, P = 0.014), but not with the LA area. Multiple regression analysis with adjustments identified 3 %ODI ≥30 (3.088, 1.078–8.851, P = 0.036) as being significantly associated with the %LVA.

Conclusions

In patients with AF complicated by OSA, significant increase of the LVA, but not of the LA area, was observed. The intermittent hypoxia severity was significantly associated with the LVA. These results suggest that intermittent hypoxia by OSA might be one of the mechanisms of electro-anatomical remodeling of the LA, possibly preceding structural remodeling represented by LA enlargement, in patients with AF.

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来源期刊

IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

10.30%

发文量

216

审稿时长

56 days

期刊介绍： IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.