134972 20260217205536.0 doi 10.1152/ajpheart.00760.2023 sideral 138464 ART-2024-138464 eng Ebrahimian, Serajeddin Beat-to-beat cardiac repolarization lability increases during hypoxemia and arousals in obstructive sleep apnea patients 2024 Access copy available to the general public Unrestricted Obstructive sleep apnea (OSA) is associated with the progression of cardiovascular diseases, arrhythmias, and sudden cardiac death (SCD). However, the acute impacts of OSA and its consequences on heart function are not yet fully elucidated. We hypothesized that desaturation events acutely destabilize ventricular repolarization, and the presence of accompanying arousals magnifies this destabilization. Ventricular repolarization lability measures, comprising heart rate corrected QT (QTc), short-time-variability of QT (STVQT), and QT variability index (QTVI), were calculated before, during, and after 20,955 desaturations from lead II electrocardiography signals of 492 patients with suspected OSA (52% men). Variations in repolarization parameters were assessed during and after desaturations, both with and without accompanying arousals, and groupwise comparisons were performed based on desaturation duration and depth. Regression analyses were used to investigate the influence of confounding factors, comorbidities, and medications. The standard deviation (SD) of QT, mean QTc, SDQTc, and STVQT increased significantly (P < 0.01), whereas QTVI decreased (P < 0.01) during and after desaturations. The changes in SDQT, mean QTc, SDQTc, and QTVI were significantly amplified (P < 0.01) in the presence of accompanying arousals. Desaturation depth was an independent predictor of increased SDQTc (β = 0.405, P < 0.01), STVQT (β = 0.151, P < 0.01), and QTVI (β = 0.009, P < 0.01) during desaturation. Desaturations cause acute changes in ventricular repolarization, with deeper desaturations and accompanying arousals independently contributing to increased ventricular repolarization lability. This may partially explain the increased risk of arrhythmias and SCD in patients with OSA, especially when the OSA phenotype includes high hypoxic load and fragmented sleep. info:eu-repo/grantAgreement/ES/DGA/T39-23R info:eu-repo/grantAgreement/EC/H2020/965417/EU/Revolution of sleep diagnostics and personalized health care based on digital diagnostics and therapeutics with health data integration/SLEEP REVOLUTION This project has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No H2020 965417-SLEEP REVOLUTION info:eu-repo/grantAgreement/ES/MICINN/PID2021-126734OB-C21 info:eu-repo/semantics/openAccess by https://creativecommons.org/licenses/by/4.0/deed.es 4.1 2024 CARDIAC & CARDIOVASCULAR SYSTEMS 51 / 231 = 0.221 2024 Q1 T1 PHYSIOLOGY 13 / 87 = 0.149 2024 Q1 T1 PERIPHERAL VASCULAR DISEASE 21 / 98 = 0.214 2024 Q1 T1 1.464 2024 Cardiology and Cardiovascular Medicine 2024 Q1 Physiology (medical) 2024 Q1 Physiology 2024 Q1 8.1 2024 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Sillanmäki, Saara Hietakoste, Salla Kulkas, Antti Töyräs, Juha Bailón, Raquel Universidad de Zaragoza (orcid)0000-0003-1272-0550 Hernando, David (orcid)0000-0002-1462-4880 Lombardi, Carolina Grote, Ludger Bonsignore, Maria R. Saaresranta, Tarja Pépin, Jean-Louis Leppänen, Timo Kainulainen, Samu 5008 800 Universidad de Zaragoza Dpto. Ingeniería Electrón.Com. Área Teoría Señal y Comunicac. 326, 5 (2024), H1094-H1104 Am. j. physiol, Heart circ. physiol. AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY 0363-6135 2161244 http://zaguan.unizar.es/record/134972/files/texto_completo.pdf Versión publicada 3180020 http://zaguan.unizar.es/record/134972/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:134972 articulos driver 2026-02-17-20:34:26 ARTICLE