SAĞLIKLI BİREYLERDE SİMÜLE OBSTRÜKTİF APNEDE ATRİYAL ELEKTROMEKANİK GECİKMENİN DEĞERLENDİRİLMESİ

Yıl 2022, Cilt: 24 Sayı: 2, 343 - 349, 31.08.2022

Sinan Cemgil Özbek

https://doi.org/10.24938/kutfd.1092531

Öz

Amaç: Çalışmalar, obstrüktif uyku apnesinin, atriyal fibrilasyon gibi artmış disritmi riskine işaret ettiğini ileri sürmektedir. Atriyal elektriksel aktivitenin başlangıcı ile atriyal kontraksiyonun başlangıcı arasındaki zaman aralığı, atriyal elektromekanik gecikme olarak tanımlanmış ve uzamış atriyal elektromekanik gecikme, atriyal fibrilasyonun bir prediktörü olarak önerilmiştir. Bu çalışmanın amacı, solunum manevraları yoluyla obstrüktif uyku apnesini simüle ederek atriyal elektromekanik gecikme üzerindeki akut etkilerini değerlendirmektir.

Gereç ve Yöntemler: Çalışmaya toplam 50 sağlıklı birey dahil edildi ve simüle edilmiş obstrüktif apne (Mueller manevrası), istemli ekspirasyon sonu santral apne ve normal solunum esnasında doku Doppler görüntüleri kaydedildi. Bu kayıtlardan intra-atriyal ve interatriyal elektromekanik gecikme ölçüldü.

Bulgular: Tüm sağlıklı deneklerde Mueller manevrası ve istemli ekspirasyon sonu santral apne sırasında interatriyal elektromekanik gecikme (Mueller Manevrası sırasında + 10.1ms; istemli ekspirasyon sonu santral apne sırasında + 8.7ms; p <0.001) ve sol intra-atriyal elektromekanik gecikme (Mueller Manevrası sırasında +7.3 ms; istemli ekspirasyon sonu santral apne sırasında + 6.7ms; p <0.001) normal solunumla karşılaştırıldığında arttı.

Sonuç: Simüle edilmiş obstrüktif uyku apnesi, sağlıklı deneklerde intra-atriyal ve interatriyal elektromekanik gecikmeyi artırdı. Bu bulgular, obstrüktif uyku apnesindeki akut intratorasik basınç değişikliğinin atriyal fibrilasyonun bağımsız bir tetikleyicisi olabileceğini gösterebilir.

Anahtar Kelimeler

Atriyal Elektromekanik Gecikme, Atrial fibrilasyon, Obstrüktif uyku apnesi

Evaluation of Atrial Electromechanical Delay in Simulated Obstructive Apnea in Healthy Individuals

Öz

Objective: Studies have suggested that obstructive sleep apnea portends an increased risk of dysrhythmia, such as atrial fibrillation. The time interval between the onset of atrial electrical activity and the onset of atrial contraction has been defined as atrial electromechanical delay, and prolonged atrial electromechanical delay has been proposed as a predictor of atrial fibrillation. The aim of this study is to simulate obstructive sleep apnea through respiratory maneuvers to evaluate its acute effects on atrial electromechanical delay.

Material and Methods: A total of 50 healthy individuals were included in the study and tissue Doppler images were recorded during simulated obstructive apnea (Mueller maneuver, voluntary end-expiratory central apnea and normal breathing. From these recordings intra-atrial and interatrial electromechanical delay were measured.

Results: Interatrial electromechanical delay (+10.1ms during Mueller maneuver; +8.7ms during voluntary end-expiratory central apnea; p<0.001) and left intra-atrial electromechanical delay (+7.3 ms during Mueller maneuver; +6.7ms during voluntary end-expiratory central apnea; p<0.001) increased during Mueller maneuver and voluntary end-expiratory central apnea compared to normal breathing in all healthy subjects.

Conclusion: Simulated obstructive sleep apnea increased intra-atrial and interatrial electromechanical delay in healthy subjects. These findings may indicate that acute intrathoracic pressure change in obstructive sleep apnea may be an independent trigger of atrial fibrillation.

Anahtar Kelimeler

Atrial fibrillation, Obstructive sleep apnea, Atrial Electromechanical Delay

Kaynakça

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