Application Of Dynamic Electrocardiogram For Screening Sleep Apnea Syndrome In Coronary Slow Flow Phenomenon

ObjectivesTo apply the dynamic electrocardiogram(ECG,Holter)to observe the occurrence of Sleep Apnea Syndrome(SAS)in patients with coronary slow flow phenomenon(CSFP),and study the correlation between SAS and CSFP.MethodsPatients who undergwent coronary angiography for suspected of coronary heart disease were selected and divided into CSFP group and control group according to the coronary angiography results.All patients underwent DMS Holter inspection and SAS was screened with Holter.Ages,weight,smoking,drinking,snoring history,past history of hypertension,diabetes,hyperlipemia and other general information were all recorded in both groups.Blood cells,fasting blood glucose,triglyceride and other biochemical indicators were determined.The screening criteria in Dynamic electrocardiogram trends was : more than 3consecutive equidistant peaks and valleys of state in the heart rate,more than 3 consecutive interval apnea or hypopnea morphology in respiratory wave,with the total number of 5 times of the criteria for screening SAS patients.Compare the correlation between SAS and CSFP.Results1?Comparison of two groups of patients with demographic and clinical data: In 130 enrolled patients,60 cases were included in the CSFP group,average age(54.90±10.27)years old,men of 39 cases,accounting for 65.0%.70 cases were in the control group,average age(53.87±9.60)years old,men of 26 cases,accounting for 37.1%.The two groups did not exhibit statistically significant differences in age,hypertension,diabetes mellitus,hyperlipidemia,and sleep quality index.Male/female ratio,snoring,BMI,smoking,alcohol drinking,SAS were all significantly higher in the CSFP group compared with the control group(P<0.05).2?Comparison of laboratory and echocardiography findings of two groups of patients.The two study groups did not significantly differ in most laboratory tests: fasting blood glucose,creatinine,blood cell count(red blood cells,white blood cells,platelets),hemoglobin,total cholesterol,triglyceride,low density lipoprotein,and AST,ALT levels.(p>0.05).3?All petients underwent ECG inspection and were analysised by respiration wave method and CVHR method.Among CSFP group,a total number of 36 cases were diagnosed as SAS,accounting for 60%,of which,15 with mild SAS(25.0%),21 with moderate SAS(33.3%)and 1 with severe SAS(1.7%).In the control group,16 cases were diagnosed as SAS,accounting for 22.9%,of which,15 with mild SAS(15.7%),5 with moderate SAS(7.1%)and 0 with severe SAS.SAS incidence in the CSFP group(60.0%)was significantly higher than in the control group(15.7%)(p<0.05).4?In uivariate correlation analysis,TFC was related to gender(r=0.378,P=0.001)?weight(r=0.332,p=0.041)?BMI(r=0.486,p=0.032)?snoring(r=0.317,p=0.017)?smoking(r=0.564,p=0.010)?and SAS(r=0.465,p=0.013).5?In Logistic regression modle,Body mass index,smoking and SAS were independently correlated with the CSFP incidence,with OR 1.167(1.048~1.297),2.896(2.276~3.683)and5.751(2.984~9.493).Moreover,after controlling facors of BMI and smoking,SAS was still proved to be the risk factor of CSFP,with OR 10.446(5.604~19.539).Conclusion1?SAS is associated with CSFP.SAS is an independent risk factor of CSFP.2?ECG is an easy,convenient,practical and reliable method to detect SAS.For its great effect in screening SAS,ECG can be recommended for clinical diagnosis.