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Presence of Fragmented QRS Complexes in Patients with obstructive sleep apnea Syndrome

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Chinese Medical Journal 2015年第16期128卷 2141-2146页

作者： Muhammet Rasit Sayin Murat Altuntas Ziyaeddin Aktop Ibrahim I Oz Nesimi Yavuz Ibrahim Akpinar Erol Sagatli Turgut Karabag Mustafa Aydin Department of Cardiology School of MedicineBulent Ecevit UniversityZonguldakTurkey Department of Pulmonology Uzun Mehmet State HospitalZonguldakTurkey Department of Radiology School of MedicineBulent Ecevit UniversityZonguldakTurkey Department of Cardiology Ataturk State Hospital Zonguldak Turkey

Background：obstructive sleep apnea syndrome （OSAS） is a disease with increasing prevalence,which is mainly characterized by increased cardiopulmonary mortality and *** is well-known that OSAS patients have increased prevalence of cardiovascular diseases including coronary heart disease,heart failure,and *** aim of this study was to evaluate the presence of prolonged and fragmented QRS complexes,which have previously been associated with cardiovascular mortality,in OSAS ***：Our study included 51 patients （mean age 41.6 ± 10.1 years） who were recently diagnosed with OSAS （apnea-hypopnea index [AHI] ≥5 events/h） and never received *** control group consisted of 34 volunteers （mean age 43.1 ± 11.6 years） in whom OSAS was excluded （AHI 〈5 events/h）.The longest QRS complexes was measured in the 12-lead electrocardiogram （ECG） and the presence of fragmentation in QRS complexes was ***：Fragmented QRS frequency was significantly higher in patients with OSAS （n =31 [61%] vs.n =12 [35%],P =0.021）.QRS and QTc durations were also significantly longer in OSAS patients than controls （99.8 ± 13.9 ms vs.84.7 ± 14.3 ms,P 〈 0.001;411.4 ± 26.9 ms vs.390.1 ± 32.2 ms,P =0.001,respectively）.Analysis of the patient and controls groups combined revealed a weak-moderate correlation between AHI and QRS duration （r =0.292,P =0.070）.OSAS group had no correlation between AHI and QRS duration （r =-0.231,P =0.203）.Conclusions：In our study fragmented QRS frequency and QRS duration were found to increase in OSAS *** parameters are related with increased cardiovascular *** the prognostic importance of ECG parameters,it may be reasonable to recommend more detailed evaluation of OSAS patients with fragmented or prolonged QRS complexes with respect to presence of cardiovascular diseases.

关键词： Electrocardiogram Fragmented QRS obstructive sleep apnea QRS Duration QT Duration

Relationship of daytime blood pressure and severity of obstructive sleep apnea among Chinese： a multi-center investigation in China

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Chinese Medical Journal 2010年第1期000卷 18-22页

作者： HE Quan-ying FENG Jing ZHANG Xi-long LIANG Zong-an HUANG Shao-guang KANG Jian WANG Guang-fa ZHANG Li-qiang MA Li-jun, WANG Bei, LIN Qi-chang, ZHANG Jing-nong, LIU Hui-guo, LUO Yuan-ming,LIU Jian-hong, WANG Shi, XIAO Gao-hui, LU Gan, ZHANG Jin, FENG Xue-wei and CHEN Bao-yuan MA Li-jun WANG Bei LIN Qi-chang ZHANG Jing-nong LIU Hui-guo LUO Yuan-ming LIU Jian-hong WANG Shi XIAO Gao-hui LU Gan ZHANG Jin FENG Xue-wei CHEN Bao-yuan Department of Respiratory Diseases Beijing University People'sHospital Beijing 100044 China Department ofRespiratory Diseases Tianjin Medical University GeneralHospital Tianjin 300052 China Department of Respiratory Diseases First Affiliated Hospital ofNanjing Medical University Nanjing 210029 China Department of Respiratory Diseases Huaxi Hospital SichuanUniversity Chengdu Sichuan 610041 China Department of Respiratory Diseases Ruijin Hospital S-hanghaiJiao Tong University School of Medicine Shanghai 200025 China Department of Respiratory Diseases First AffiliatedHospital of China Medical University Shenyang Liaoning110001 China Department of Respiratory Diseases Peking University First Hospital Beijing 100034 China Department of Respiratory Diseases Peking University ThirdHospital Beijing 100083 China Department ofRespiratory Diseases Henan Provincial People's HospitalZhengzhou Henan 450003 China Department ofRespiratory Diseases Second Affiliated Hospital of ShanxiMedical University Taiyuan Shanxi 030001 China Department of Respiratory Diseases First Affiliated Hospital ofFujian Medical University Fuzhou Fujian 350005 China Department of Respiratory Diseases Union Hospital TongjiMedical College Huazhong University of Science and TechnologyWuhan Hubei 430022 China Department ofRespiratory Diseases Tongji Hospital Tongji Medical CollegeHuazhong University of Science and Technology Wuhan Hubei430030 China Guangzhou Institute of RespiratoryDisease First Affiliated Hospital of Guangzhou Medical CollegeGuangzhou Guangdong 510120 China Department ofRespiratory Diseases Guangxi Zhuang Autonomous RegionPeople's Hospital Nanning Guangxi 530021 China Department of Respiratory Diseases Central Hospital of ShenyangMedical College Shenyang Liaoning 110024 China Department of Respiratory Diseases Beijing Gongan HospitalBeijing 100006 China Department of RespiratoryDiseases Jiangsu Senility Hospital Nanjing Jiangsu 210024China Department of Respiratory Disea

Background Epidemiologic studies have shown an independent and definite association between obstructive sleep apnea （OSA） and hypertension. This study aimed to define the association between daytime blood pressure and severity of OSA in Chinese population in mainland of China. Methods Twenty university hospital sleep centers in mainland of China were invited by the Chinese Medical Association （CMA） to participate in this epidemiologic study and 2297 consecutive patients （aged 18-85 years; 1981 males and 316 females） referred to these twenty sleep centers for evaluation of OSA between January 2004 and April 2006 were prospectively enrolled. Nocturnal polysomnography was performed in each patient, and disease severity was assessed based on the apnea-hypopnea index （AHI）. These patients were classfied into four groups： non-apneic control （control, n=257） with AHI 〈5 episodes/hour; mild sleep apnea （mild, n=402） with AHI 〉5 and 〈15 episodes/hour; moderate sleep apnea （moderate, n=460） with AHI 〉15 and 〈30 episodes/hour and severe sleep apnea （severe, n=1178） with AHI 〉30 episodes/hour. Daytime blood pressure measurements were performed under standardized conditions in each patient at 10 a.m. in office on the day of referring to sleep centers for getting average value. All the patients were requested to quit medications related to blood pressure for three days before the day of assessing. Results Both daytime systolic blood pressure and diastolic blood pressure values were significantly related to AHI positively （r = 0.201 and 0.276, respectively; both P values 〈0.001） and to nadir nocturnal oxygen saturation negatively （r = -0.215 and -0.277, respectively; both P values 〈0.001）, which were the parameters of OSA severity. In two special designed mean plots, means of daytime systolic and diastolic blood pressure increased gradually with increasing AHI. Beyond AHI of 61-65, this increasing trend reached a plateau. Conclusions The results showed that OSA severity was associ

关键词： obstructive sleep apnea hypertension epidemiology blood pressure polysomnography

Correlation between severity of endoscopic findings and apnea-hypopnea index in patients with gastroesophageal reflux disease and obstructive sleep apnea

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World Journal of Gastroenterology 2005年第6期11卷 839-841页

作者： Pál Demeter Katalin Várdi Visy Pál Magyar Department of Gastroenterology Department of Pulmonology

AIM: To assess the relationship between severity of gastroesophageal reflux disease and apnea-hypopnea index (AHI) as an indicator of the severity of obstructive sleep apnea. METHODS: Data of 57 patients with proven obstructive sleep apnea and gastroesophageal reflux disease were analyzed. Patients were divided into two groups according to severity of the sleep apnea: 'mild-moderate' (A)-AHI 5≥5-30, n=27, 'severe' (B)-AHI >30, n=30. All patients underwent apnea monitoring during the night, upper panendoscopy and were asked about typical reflux symptoms. RESULTS: All examined patients in both groups showed a significant overweight and there was a positive correlation between body mass index and the degree of sleep apnea (P = 0.0002). The occurence of erosive reflux disease was significantly higher in 'severe' group (P = 0.0001). Using a logistic regression analysis a positive correlation was found between the endoscopic severity of reflux disease and the AHI (P = 0.016). Forty-nine point five percent of the patients experienced the typical symptoms of reflux disease at least three times a week and there was no significant difference between the two groups. CONCLUSION: A positive correlation can be found between the severity of gastroesophageal reflux disease and obstructive sleep apnea.

关键词： obstructive sleep apnea Gastroesophageal reflux disease Severity Correlation

Increased serum levels of C-reactive protein and matrix metalloproteinase-9 in obstructive sleep apnea syndrome

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Chinese Medical Journal 2007年第17期120卷 1482-1486页

作者： YEJin LIU Hui LI Yuan LIU Xian ZHU Jie-ming sleep Disorders Centre and Department of 0tolaryngology-Headand Neck Surgery Third Affiliated Hospital of Sun Yat-sen University Guangzhou510630 China Department of Pulmonary Diseases Third Affiliated Hospital of Sun Yat-sen University Guangzhou510630 China Department of Cardiology Third Affiliated Hospital of Sun Yat-sen University Guangzhou510630 China

Background obstructive sleep apnea syndrome （OSAS）, characterized by intermittent hypoxia/reoxygenation （IHR）, has been identified as an independent risk factor for cardiovascular diseases （CVD）. The CVD biomarkers associated with OSAS have not been thoroughly investigated. Methods Fifty-one men with OSAS recently diagnosed by polysomnography were classified into two groups according to the severity of apnea： moderate to severe OSAS group （n=- 28） and mild OSAS group （n=- 23）. Twenty-five obese men, of comparable age and body mass index （BMI）, without OSAS were chosen as control subjects. Serum metabolic variables, C-reactive protein （CRP） and matrix metalloproteinase-9 （MMP-9） were measured. Spearman correlation and regression analysis were performed. Results Serum concentrations of CRP and MMP-9 were significantly higher in 51 OSAS patients than in 25 control subjects. Levels of CRP and MMP-9 were significantly higher in patients with moderate to severe OSAS than in patients with mild OSAS or in obese control subjects. A positive correlation was found between levels of CRP and MMP-9 in OSAS patients. Regression analysis showed that after adjusting for age and BMI, apnea/hypopnea index （AHI） significantly correlated with serum concentrations of CRP and MMP-9 in patients with OSAS. Conclusions AHI, mirroring the frequency of IHR, was a predictor of enhanced circulating CVD biomarkers MMP-9 and CRP. Our data support the theory that IHR contributes to the upregulation of the inflammatory factors in OSAS patients.

关键词： cardiovascular diseases C-reactive protein intermittent hypoxia matrix metalloproteinase obstructive sleep apnea

Does obstructive sleep apnea associate with atrial fibrillation？

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Chinese Medical Journal 2008年第2期121卷 172-174页

作者： TAO Hai-long LONG De-yong DONG Jian-zeng MA Chang-sheng Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

obstructive sleep apnea （OSA） is a disorder in which transient obstruction （complete or partial） of the airway during sleep causes loud snoring, oxyhemoglobin desaturation and frequent *** has been identified to relate to many cardiovascular diseases such as hypertension, coronary heart disease, heart failure, and cardiac arrhythmia. In this article, we attempt to discuss the association between OSA and atrial fibrillation （AF） while reviewing the recent data on OSA and AF.

关键词： obstructive sleep apnea atrial fibrillation

Prevalence and incidence of hypertension in obstructive sleep apnea patients and the relationship between obstructive sleep apnea and its confounders

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Chinese Medical Journal 2009年第12期122卷 1464-1468页

作者： FENG Jing CHEN Bao-yuan Department of Respiratory Disease Tianjin Medical University General Hospital Tianjin 300052 China

Based on available population-based studies, obstructive sleep apnea （OSA） associated with accompanying daytime sleepiness affects 3% to 7% of adult men and 2% to 5% of adult women in the general population. In some population subsets, like obese or older people, this prevalence is even higher. The health risk in OSA patients shows a strong association with acute cardiovascular events such as stroke, myocardial infarction and nocturnal sudden death. And with chronic conditions such as coronary artery disease,

关键词： obstructive sleep apnea hypertension weight age sex gene race

Elevated Serum Liver Enzymes in Patients with obstructive sleep apnea-hypopnea Syndrome

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Chinese Medical Journal 2015年第22期128卷 2983-2987页

作者： Jie Li Yan-Lin Zhang Rui Chen Yi Wang Kang-Ping Xiong Jun-Ying Huang Fei Han Chun-Feng Liu Department of Neurology and sleep Center Second Affiliated Hospital of Soochow University Suzhou Jiangsu 215004 China Institute of Neuroscience Soochow University Suzhou Jiangsu 215123 China Beijing Key Laboratory for Parkinson's Disease Beijing 100053 China

Background： obstructive sleep apnea-hypopnea syndrome （OSAS） is associated with elevated liver enzymes and fatty liver. The purpose of this study was to measure serum liver enzyme levels in patients evaluated by polysomnography （PSG） and the f：actors associated with liver injury in OSAS patients. Methods： All patients referred to PSG for evaluation of sleep apnea symptoms between June 2011 and November 2014 were included in this study. Demographic data and PSG parameters were recorded. Serum alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transferase levels were systematically measured. OSAS patients were divided into mild, moderate, and severe groups according to the apnea-hypopnea index （AHI） values of 5-14 events/h, 15-29 events/h, and ≥30 events/h. Results： A total of 540 patients were enrolled in this study; among these patients, 386 were male. Elevated liver enzymes were present in 42.3% of OSAS patients （32.4% in mild/moderate group; 51.0% in severe group） and 28.1% patients without OSAS. Patients with OSAS had higher body mass index （BMI）（P 〈 0.01）. In the bivariate correlation, the liver enzymes level was negatively correlated with age and the lowest arterial oxygen saturation （SaO2）, and was positively correlated with BMI, oxygen desaturation index, percent of total time with oxygen saturation level 〈90% （TS90%）, AHI, total cholesterol （TC）, and triglyceride （TG）. In logistic regression analysis, Age, BMI, TS90%, TC, and TG were included in the regression equation. Conclusions： Our data suggest that OSAS is a risk factor for elevated liver enzymes. The severity of OSAS is correlated with liver enzyme levels; we hypothesize that hypoxia is one of main causes of liver damage in patients with OSAS.

关键词： Hypoxia Liver Enzyme obstructive sleep apnea

Serum Sex Hormone Levels in Different Severity of Male Adult obstructive sleep apnea-hypopnea Syndrome in East Asians

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2015年第4期35卷 553-557页

作者：董家琪陈雄肖英张瑞牛勋孔维佳 Department of Otolaryngology Union HospitalTongji Medical CollegeHuazhong University of Science and Technology

Summary： obstructive sleep apnea-hypopnea syndrome （OSAHS） is a serious health issue, which can impact the hormone secretion. The aim of this study is to analyze the relationship between serum sex hormone concentrations and different severity degree of OSAHS, and to evaluate the influence of OSAHS on sex hormone levels. We enrolled 116 subjects who were subjected to polysomnography （PSG）. They were divided into three groups： control group （n=10） [apnea hypopnea index （AHI）〈5/h], mild-moderate OSAHS group ,（n=15）（5〈AHI〈30/h）, and severe OSAHS group （n=91）（AHI〉30/h）. The patients in OSAHS group were subdivided into obesity and non-obesity subgroups. The parameters such as AHI, body mass index （BMI）, lowest oxygen saturation （LSaO2）, and mean oxygen saturation （MSaO2） were recorded. Serum levels of testosterone, polactin, estradiol, follicle stimulating hormone （FSH） and luteinizing hormone （LH） were determined in the morning immediately after waking up. Mean levels of hormones were compared among groups. The correlation between hormone levels and sleep-breathing parameters was analyzed. No significant differences in serum sex hormone levels were found among control, mild-moderate OSAHS, and severe OSAHS groups （P〉0.05）. There was no cor- relation between AHI and sex hormone levels （P〉0.05）. Testosterone was significantly negatively cor- related with BMI （P〈0.05）. These results suggested that BMI might have a direct effect on testosterone level, and it might be an important factor affecting testosterone level in male OSAHS patients, and there may be no correlation between severity of OSAHS and sex hormones levels.

关键词： obstructive sleep apnea sex hormone testosterone body mass index

Disease characteristics and neuropathological changes associated with cognitive dysfunction in obstructive sleep apnea

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Pediatric Investigation 2021年第1期5卷 52-57页

作者： Tingting Ji Xiaodan Li Yue Qiu Lin Mei Xinbei Jia Jun Tai Yongli Guo Jie Zhang Shengcai Wang Xin Ni Department of Otolaryngology Head and Neck SurgeryBeijing Children's HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina Department of Otorhinolaryngology Beijing Children’s HospitalCapital Institute of PediatricsBeijingChina Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck SurgeryBeijing Pediatric Research InstituteBeijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijingChina

obstructive sleep apnea(OSA)is a common sleep-disordered breathing disease that often leads to many comorbidities(e.g.,cognitive dysfunction),which adversely affect the quality of life for patients with *** far,the underlying mechanisms of this dysfunction remain *** studies have focused on OSA-related characteristics,including intermittent hypoxemia and sleep *** is increasing emphasis on neuroimaging studies to explore underlying relationships between neuropathological changes and cognitive *** article reviews recent research progress concerning cognitive dysfunction associated with OSA to reveal potential mechanisms that contribute to this dysfunction.

关键词： obstructive sleep apnea Cognitive dysfunction Neuropathological mechanisms