Effect Of Obstructive Sleep Apnea On Ventricular Repolarization In Obese Patients

Background: Obstructive sleep apnea(OSA)is a common phenomenon,which can affect the respiratory system,circulatory system,cerebrovascular system and other multi system respiratory and sleep disorders.Although the incidence rate of this disease is high,it is very easy to be ignored by people and medical personnel.Long term illness is prone to cause hypertension,type 2 diabetes,coronary heart disease,arrhythmia,memory decline,gastroesophageal reflux and other diseases.In addition,with the development of social economy,the prevalence of obesity is increasing.With the increasing number of obese patients,a series of complications caused by obesity have brought great distress to patients and their families,including the occurrence of OSA.Obesity is the key pathogenic factor of OSA.In obese people,especially those with OSA,the adverse events caused by OSA are even more unimaginable.Many studies have shown that the incidence rate and mortality of cardiovascular diseases in OSA and simple obesity patients are higher than those in the general population,which seriously affects the survival and quality of life of such patients.Compared with ordinary people,the incidence of malignant arrhythmia and sudden cardiac death in this group is not low.In order to avoid the occurrence of such events,we urgently need to be able to give us a certain warning through simple ECG indicators at an early stage,so that we can take timely intervention measures,such as weight control,use of respirators,etc.,to avoid the occurrence of adverse events.Clinical central organ repolarization can affect the heart,and prolonged repolarization can cause sudden cardiac death.For obese patients with OSA,the evolution of ventricular repolarization index and its correlation with the degree of OSA need to be further explored.Obiective: To explore the impact of obstructive sleep apnea(OSA)on QT interval and dispersion of ventricular repolarization index in obese people,and further analyze the relationship with the severity of OSA,which can provide us with early warning and avoid the occurrence of adverse consequences of malignant heart disease.Methods: The study included 37 control subjects and 228 obese patients.All participants were required to complete the questionnaire survey,12-lead ECG and 3 types of sleep monitoring.According to the patient’s BMI,all participants were divided into four groups: grade I obesity,grade II obesity,grade III obesity and control group,and the clinical data such as body mass index(BMI),QT interval(QT),QT interval dispersion(QTd),corrected QT interval(QTc),corrected QT interval dispersion(QTcd)were further compared among the four groups.Obese people were divided into non-OSA and OSA groups according to the reference apnea-hypopnea index(AHI),and OSA group was further divided into light,medium and heavy groups.The relationship between the severity of OSA and the evolution of ventricular repolarization index in obese people was further explored by analyzing the clinical data of BMI,minimum blood oxygen saturation(Min Sp O2),average blood oxygen saturation(Avg Sp O2),QT,QTc,QTd,QTcd and other four groups.Results: According to the degree of obesity,BMI,QTd,QTc and QTcd of the four groups were significantly different(P<0.05);According to AHI,there were significant differences in AHI,QTd,QTcd,BMI,LSp O2 and MSp O2 among the four groups of obese patients(P<0.05).Univariate analysis showed that QTd and QTcd of patients with OSA were positively correlated with AHI(P<0.05),and negatively correlated with Avg Sp O2 and Min Sp O2(P<0.05);Multivariate analysis showed that QTd and QTcd of patients with OSA were positively correlated with AHI(P<0.05),while the others were not correlated(P>0.05).Conclusions: QTd and QTcd increased with the aggravation of obesity grade,significantly prolonged compared with the control group.Among obese patients,QTd and QTcd with OSA were significantly higher than those of non-OSA group,and showed positive correlation with AHI,revealing that the more serious OSA was,the longer the cardiac repolarization index was,and the more likely to cause adverse cardiac events.