The Related Investigation About Heart Rate Variability And Arrhythmia In Obstructive Sleep Apnea Syndrome Patients

Objective:The aim of this study is to explore the obstructive sleep apnea syndrome (OSAS) patients with arrhythmia in heart rate variability of correlation,to provid the valuable clinical reference information for the prevention,treatment and anti-arrhythmic drug efficacy monitoring.Methods:81 outpatients and inpatients were enrolled to investigate from February 2009 to February 2009.The contents monitored included the general condition,sleep apnea and 24 hours dynamic electrocardiogram monitoring.The disease history,physical examination,echocardiography and biochemical examination were performed in all patients. The diseases that be excluded were as follow:congenital heart diseases,central sleep apnea syndrome(CSAS),a serious long-term alcohol drunk,serious lung diseases,kidney diseases,brain diseases and the recent use of drugs for sleep.According to the monitoring polysomnography,take the standard that the apnea hyponea index(AHI) is more than five times,to divide two groups into OSAS(experimental group) and no OSAS(control group). The experimental group is including 48 cases,males 37 cases,females 11,age58-93(69.7±8.8) years,the control group is including 33 cases,males 23,females 10,age59-89(69.8±8.5) years.All the people were under the echocardiography monitoring to get cardiac structure indexes,24 hours dynamic electrocardiogram monitoring to get heart rate variability and arrhythmia index.All experimental data were analyzed by SPSS Statistics 17.0 statistical package.Measurement data were expressed as(?)±s and counting data were expressed as frequency.Inter-group quantitative data comparison is using t-test and that chi-square test is used in inter-group qualitative data comparison.P＜0.05 is considered statistically significant.The correlation analysis was performed between independent variable and dependent ariable.Linear correlation analysis was used when data were normal distribution and orderly variance(calculate Pearson correlation coefficient),on the contrary, the rank correlation analysis were performed when the data is classification variables of the variable value is non-normal distribution or unknown(calculate Spearman correlation coefficient).When correlational coefficient r＞0.7,highly correlational relation between two variables was considered;when 0.7＞r＞0.4,moderate correlational relation between two variables,when r＜0.4,low correlation relation between two variables was.Result:Generally in terms of gender,age,height,weight,and body mass index (BMI),waist,hip circumference,waist-hip ratio(WHR),smoking(daily smoking), drinking(daily drinking),hypertension sicken or not,blood press(SBP/DBP)level, hypertension's course of the disease,diabetes sicken or not,fasting plasma glucose(FPG) and postprandial glucose(PPBS),cardiac valvular disease sicken or not,comparisons between the experimental group and control group were not statistically difference.The neck circumferenceof experimental group's are higher than those of control group's Nc: (40.88±3.62cm vs 38.12±3.45cm),LDL-c:(3.78±0.80mmol/L vs 2.99±0.89mmol/L), hs-CRP:(15.19±8.97mmol/L vs 9.42±1.92mmol/L),but the HDL-C(0.89±0.21 mmol/L vs1.10±0.23 mmol/L) is lower.Comparison is statistically difference(P＜0.05).The heart structure index,including left atrial diameter(LAId),the right atrium diameter (RAId),interventricular septal thickness(IVST),left ventricular internal diameter at end-diastole(LVPWT),left ventricle myocardium(LVM),left ventricle myocardium index(LVMI) in experimental group were higher than those in control group.Comparison is statistically difference(p＜0.05).The heart rate variability index such as standard deviation of NN-intervals(SDNN),standard deviation of average NN-intervals(SDANN) in experimental group were lower than those in control group.Comparison is statistically difference(p＜0.05).The number of patients with arrhythmia in experimental group is significantly higher than control group.The slowest rate,fastest rate,average rate,atrial fibrillation,atrial flutter,sinus stopped,bundle branch conduction block,comparisons between the experimental group and control group are not statistically difference.But,the incidence of ventricular premature beat,pairs ventricular premature beat,ventricular tachycardia,supraventricular premature beat,pairs supraventricular premature beat, supraventricular tachycardia,atrioventricular block in experimental group is higher than control group,is statistically difference(p＜0.05).By correlation analysis,it is showed that the heart of the structure indicators are correlated with indicators of hypoxic-time moderately,they are also correlated with indicators of degree of hypoxia moderately and correlated with comprehensive indicators of hypoxia moderately.The arrhythmia incidence is correlated with indicators of hypoxic time and degree lowly to moderately.The heart rate variability indexs are correlated with arrhythmia incidence lowly to moderately.Conclusion:The arrhythmia incidence in OSAS patients is more serious than no OSAS patients,is related to long-term intermittent hypoxia and hypercapnia,cardiac structure change,fluid factors alteration,autonomic nervous disorders and so on.This research is coverage of sleep apnea syndrome patients the cardiac structure change, correlation between heart rate variability and arrhythmia,and the results will provide valuable information to evaluate the risk of OSAS patients with arrhythmia,guide anti-arrhythmic drug efficacy's monitoring,improved the diagnosis and treatment of intractable arrhythmias.