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Year 2014, Volume: 4 Issue: 1, 6 - 9, 21.07.2014

Savaş Sarıkaya Şafak Şahin , Lütfi Akyol Fatih Altunkaş Turan Aktaş Yavuz İntepe Yunus Yılmaz

Abstract

Aim Obstructive sleep apnea is a highly prevalent disease, affecting 4% of adult in western countries. Heart rate variability is decreased in obstructive sleep apnea patients, and it is associated with poor cardiovascular outcome. We aimed to evaluate autonomic function in obstructive sleep apnea patients with heart rate variability. Material and Method We selected 30 obstructive sleep apnea patients without comorbidity and 30 healthy individual. All patients underwent 24 hours holter monitoring to assess heart rate variability. Results Age and gender were not different in two groups. Body mass index was higher in obstructive sleep apnea patients compared to the control group (36.43±6.8 and 27.21±36.4, p=0.001 respectively). SDNN was lower in obstructive sleep apnea patients than the control group (128.73±31.27 and 144.80±37.74, p=0.021 respectively). LF and LF/HF value were higher in patients with obstructive sleep apnea compared to those with control (680.76±319.47 vs. 524.87±348.78, p=0.02 and 4.745±2.16 vs. 2.9583±1.79, p=0.001 respectively). HF was lower in obstructive sleep apnea patients compared to control group (238.00±96.07 and 167.57±75.09, p=0.007 respectively). Conclusion We detected reduced heart rate variability and impaired balance between sympathetic-parasympathetic systems in OSAS patients. OSAS patients should be closely followed for developing arrhythmias.

Keywords

Obstructive sleep apnea Heart rate variability Arrhythmia

References

  • Patil SP, Schneider H, Schwartz AR, Smith PL. Adult obstructive sleep apnea: pathophysiology and diagnosis. Chest. 2007;132(1):325-37.
  • Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med. 2002;165(9):1217-39.
  • Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep. 1999;22(5):667-89.
  • Sztajzel J. Heart rate variability: a noninvasive electrocardiographic method to measure the autonomic nervous system. Swiss Med Wkly. 2004;134(35-36):514-22.
  • Rajendra Acharya U, Paul Joseph K, Kannathal N, Lim CM, Suri JS. Heart rate variability: a review. Med Biol Eng Comput. 2006;44(12):1031-51.
  • Narkiewicz K, Montano N, Cogliati C, van de Borne PJ, Dyken ME, Somers VK. Altered cardiovascular variability in obstructive sleep apnea. Circulation. 1998;98(11):1071-7. 7.Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 2001;285(19):2486-97.
  • Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Eur Heart J. 1996;17(3):354-81.
  • Lee JY, Joo KJ, Kim JT, et al. Heart Rate Variability in Men with Erectile dysfunction. Int Neurourol J. 2011;15(2):87-91.
  • Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation. 1996;93(5):1043-65.
  • Hayano J, Sakakibara Y, Yamada M, Ohte N, Fujinami T, Yokoyama K, et al. Decreased Magnitude of Heart-Rate Spectral Components in Coronary-Artery Disease - Its Relation to Angiographic Severity. Circulation. 1990;81(4):1217-24.
  • Podrid PJ, Fuchs T, Candinas R. Role of the Sympathetic Nervous-System in the Genesis of Ventricular Arrhythmia. Circulation. 1990;82(2):103-13.
  • Pruvot E, Thonet G, Vesin JM, et al. Heart rate dynamics at the onset of ventricular tachyarrhythmias as retrieved from implantable cardioverter-defibrillators in patients with coronary artery disease. Circulation. 2000;101(20):2398-404.
  • La Rovere MT. Baroreflex sensitivity as a new marker for risk stratification. Zeitschrift fur Kardiologie. 2000;89 Suppl 3:44-50.
  • Bigger JT, Jr., Fleiss JL, Steinman RC, Rolnitzky LM, Kleiger RE, Rottman JN. Frequency domain measures of heart period variability and mortality after myocardial infarction. Circulation. 1992;85(1):164-71.
  • Bradley TD, Floras JS. Obstructive sleep apnoea and its cardiovascular consequences. Lancet. 2009 Jan 3;373(9657):82-93.
  • Pagani M, Lombardi F, Guzzetti S, et al. Power spectral analysis of heart rate and arterial pressure variabilities as a marker of sympatho-vagal interaction in man and conscious dog. Circ Res. 1986;59(2):178-93.
  • Bauer T, Ewig S, Schafer H, Jelen E, Omran H, Luderitz B. Heart rate variability in patients with sleep-related breathing disorders. Cardiology. 1996;87(6):492-6.

Uyku Apne Sendromlu Hastalarda Otonomik Fonksiyonların Değerlendirilmesi

Year 2014, Volume: 4 Issue: 1, 6 - 9, 21.07.2014

Savaş Sarıkaya Şafak Şahin , Lütfi Akyol Fatih Altunkaş Turan Aktaş Yavuz İntepe Yunus Yılmaz

Abstract

Amaç Uyku apne sendromu toplumda yaygın olarak görülen ve batı ülkelerindeki yetişkinlerin %5’ni etkileyen bir bozukluktur. Uyku apne sendromu olan hastalarda kalp hızı değişkenliğinin azaldığı ve olumsuz kardiyovasküler sonuçlarla ilişkili olduğu saptanmıştır. Biz bu çalışmamızda uyku apne sendromu olan hastalarda otonomik fonksiyon değerlendirmesini zaman ve frekans temelli kalp hızı değişkenliği yöntemi ile değerlendirmeyi amaçladık.

Gereç ve Yöntem Çalışmaya uyku apne sendromu tanısı alan ve ek hastalığı olmayan 30 hasta ve sağlıklı 30 kişi alındı. Hastalar uyku apne sendromu ve kontrol grubu olarak iki sınıfa ayrıldı. Tüm hastalar, kalp hızı değişkenliğini değerlendirmek üzere 24 saatlik holter kaydı altına alındı.

Bulgular Hastaların yaş ve cinsiyeti açısından aralarında istatiksel fark saptanmadı. Uyku apne sendromu grubunda vücut kitle indeksi kontrol grubuna göre yüksek olarak saptandı (36.43±6.8 ve 27.21±36.4, p=0.001 sırasıyla). SDNN değeri uyku apne sendromu grubunda sağlıklı gruba göre düşük olarak saptandı (128.73±31.27 ve 144.80±37.74, p=0.021). Frekans temelli değerlerden LF ve LF/HF, uyku apne sendromlu hastalarda kontrol grubuna göre yüksek saptandı (680.76±319.47&524.87±348.78, p=0.02 ve 4.745±2.16&2.95±1.79, p=0.001 sırasıyla). HF değeri uyku apne sendromu hastalarda kontrol grubuna göre düşük olarak saptandı (238.00±96.07 ve 167.57±75.09, p=0.007)

Sonuç Uyku apne sendromu olan hastalarda kalp hızı değişkenliğinde azalma ve sempatik ve parasempatik sistem arasındaki dengenin bozulduğunu saptadık. Uyku apne sendromu olan hastalar gelişebilecek kardiyak aritmiler yönünden dikkatlice değerlendirilmelidir.

 

Anahtar Kelimeler Uyku apne sendromu, Kalp hızı değişkenliği, Aritmi

Keywords

Uyku apne sendromu Kalp hızı değişkenliği Aritmi

References

  • Patil SP, Schneider H, Schwartz AR, Smith PL. Adult obstructive sleep apnea: pathophysiology and diagnosis. Chest. 2007;132(1):325-37.
  • Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med. 2002;165(9):1217-39.
  • Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep. 1999;22(5):667-89.
  • Sztajzel J. Heart rate variability: a noninvasive electrocardiographic method to measure the autonomic nervous system. Swiss Med Wkly. 2004;134(35-36):514-22.
  • Rajendra Acharya U, Paul Joseph K, Kannathal N, Lim CM, Suri JS. Heart rate variability: a review. Med Biol Eng Comput. 2006;44(12):1031-51.
  • Narkiewicz K, Montano N, Cogliati C, van de Borne PJ, Dyken ME, Somers VK. Altered cardiovascular variability in obstructive sleep apnea. Circulation. 1998;98(11):1071-7. 7.Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 2001;285(19):2486-97.
  • Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Eur Heart J. 1996;17(3):354-81.
  • Lee JY, Joo KJ, Kim JT, et al. Heart Rate Variability in Men with Erectile dysfunction. Int Neurourol J. 2011;15(2):87-91.
  • Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation. 1996;93(5):1043-65.
  • Hayano J, Sakakibara Y, Yamada M, Ohte N, Fujinami T, Yokoyama K, et al. Decreased Magnitude of Heart-Rate Spectral Components in Coronary-Artery Disease - Its Relation to Angiographic Severity. Circulation. 1990;81(4):1217-24.
  • Podrid PJ, Fuchs T, Candinas R. Role of the Sympathetic Nervous-System in the Genesis of Ventricular Arrhythmia. Circulation. 1990;82(2):103-13.
  • Pruvot E, Thonet G, Vesin JM, et al. Heart rate dynamics at the onset of ventricular tachyarrhythmias as retrieved from implantable cardioverter-defibrillators in patients with coronary artery disease. Circulation. 2000;101(20):2398-404.
  • La Rovere MT. Baroreflex sensitivity as a new marker for risk stratification. Zeitschrift fur Kardiologie. 2000;89 Suppl 3:44-50.
  • Bigger JT, Jr., Fleiss JL, Steinman RC, Rolnitzky LM, Kleiger RE, Rottman JN. Frequency domain measures of heart period variability and mortality after myocardial infarction. Circulation. 1992;85(1):164-71.
  • Bradley TD, Floras JS. Obstructive sleep apnoea and its cardiovascular consequences. Lancet. 2009 Jan 3;373(9657):82-93.
  • Pagani M, Lombardi F, Guzzetti S, et al. Power spectral analysis of heart rate and arterial pressure variabilities as a marker of sympatho-vagal interaction in man and conscious dog. Circ Res. 1986;59(2):178-93.
  • Bauer T, Ewig S, Schafer H, Jelen E, Omran H, Luderitz B. Heart rate variability in patients with sleep-related breathing disorders. Cardiology. 1996;87(6):492-6.
There are 17 citations in total.

Details

Primary Language Turkish
Journal Section Original Research
Authors

Savaş Sarıkaya This is me

Şafak Şahin

Lütfi Akyol This is me

Fatih Altunkaş This is me

Turan Aktaş This is me

Yavuz İntepe This is me

Yunus Yılmaz This is me

Publication Date July 21, 2014
Published in Issue Year 2014 Volume: 4 Issue: 1

Cite

APA Sarıkaya, S., Şahin, Ş., Akyol, L., Altunkaş, F., et al. (2014). Uyku Apne Sendromlu Hastalarda Otonomik Fonksiyonların Değerlendirilmesi. Çağdaş Tıp Dergisi, 4(1), 6-9.
AMA Sarıkaya S, Şahin Ş, Akyol L, Altunkaş F, Aktaş T, İntepe Y, Yılmaz Y. Uyku Apne Sendromlu Hastalarda Otonomik Fonksiyonların Değerlendirilmesi. J Contemp Med. July 2014;4(1):6-9.
Chicago Sarıkaya, Savaş, Şafak Şahin, Lütfi Akyol, Fatih Altunkaş, Turan Aktaş, Yavuz İntepe, and Yunus Yılmaz. “Uyku Apne Sendromlu Hastalarda Otonomik Fonksiyonların Değerlendirilmesi”. Çağdaş Tıp Dergisi 4, no. 1 (July 2014): 6-9.
EndNote Sarıkaya S, Şahin Ş, Akyol L, Altunkaş F, Aktaş T, İntepe Y, Yılmaz Y (July 1, 2014) Uyku Apne Sendromlu Hastalarda Otonomik Fonksiyonların Değerlendirilmesi. Çağdaş Tıp Dergisi 4 1 6–9.
IEEE S. Sarıkaya, Ş. Şahin, L. Akyol, F. Altunkaş, T. Aktaş, Y. İntepe, and Y. Yılmaz, “Uyku Apne Sendromlu Hastalarda Otonomik Fonksiyonların Değerlendirilmesi”, J Contemp Med, vol. 4, no. 1, pp. 6–9, 2014.
ISNAD Sarıkaya, Savaş et al. “Uyku Apne Sendromlu Hastalarda Otonomik Fonksiyonların Değerlendirilmesi”. Çağdaş Tıp Dergisi 4/1 (July 2014), 6-9.
JAMA Sarıkaya S, Şahin Ş, Akyol L, Altunkaş F, Aktaş T, İntepe Y, Yılmaz Y. Uyku Apne Sendromlu Hastalarda Otonomik Fonksiyonların Değerlendirilmesi. J Contemp Med. 2014;4:6–9.
MLA Sarıkaya, Savaş et al. “Uyku Apne Sendromlu Hastalarda Otonomik Fonksiyonların Değerlendirilmesi”. Çağdaş Tıp Dergisi, vol. 4, no. 1, 2014, pp. 6-9.
Vancouver Sarıkaya S, Şahin Ş, Akyol L, Altunkaş F, Aktaş T, İntepe Y, Yılmaz Y. Uyku Apne Sendromlu Hastalarda Otonomik Fonksiyonların Değerlendirilmesi. J Contemp Med. 2014;4(1):6-9.