Hypoxaemic load in sleep apnoea is associated with acute changes in T-wave amplitude

Sillanmäki, Saara ; Ebrahimian, Serajeddin ; Hietakoste, Salla ; Hernando, David ; Bailon, Raquel (Universidad de Zaragoza) ; Leppänen, Timo ; Kainulainen, Samu

Resumen: AimsObstructive sleep apnoea (OSA) imposes significant stress on the cardiovascular system and the heart. While long-term cardiac effects are understood, the immediate impact of hypoxaemia on the heart's electrophysiology lacks understanding. Our study aims to explore desaturation severity on cardiovascular repolarisation.MethodsWe retrospectively analysed ECGs from full diagnostic polysomnographies from 492 patients with suspected OSA. The analyses were conducted before, during and after 9137 nocturnal apnoea- or hypopnoea-related desaturations. The mean andsdof T-wave amplitude change from the baseline level to the level during and after desaturations (ΔTamp_meanand ΔTamp_SD) were calculated. To investigate the modulatory effects of desaturation severity, the data were divided into subgroups based on the desaturation duration (Tdes; 10 s≤Tdes<20 s, 20 s≤Tdes<30 s, 30 s≤Tdes<45 s and Tdes≥45 s) and magnitude of blood oxygen saturation drop (change in peripheral oxygen saturation (ΔSpO2); 3%≤ΔSpO2<4.5%, 4.5%≤ΔSpO2<6%, 6%≤ΔSpO2<7.5% and ΔSpO2≥7.5%) for men and women.ResultsDesaturations caused significant (p<0.01) changes in ΔTamp_meanduring and after desaturations. In men, the median ΔTamp_meanduring and after deep (ΔSpO2≥7.5%) desaturations were 21 µV and 24 µV, respectively. In women, the median ΔTamp_meanin deep desaturations was 15 µV during and 21 µV after desaturations. Similarly, the ΔTamp_SDincreased during and after deep desaturations. In regression analysis, the desaturation depth was an independent predictor for ventricular repolarisation instability.ConclusionWe found an association between the severity of nocturnal desaturations and cardiac repolarisation instability. These findings hold particular importance, as repolarisation instability has been linked with cardiovascular morbidity and could potentially serve as a trigger for arrhythmias and sudden cardiac death.

Idioma: Inglés

DOI: 10.1183/23120541.00341-2024

Año: 2024

Publicado en: ERJ Open Research 10, 5 (2024), 00341-2024
ISSN: 2312-0541

Financiación: info:eu-repo/grantAgreement/ES/DGA-FSE/T39-20R-BSICoS group
Financiación: info:eu-repo/grantAgreement/ES/MCIU-AEI-FEDER/PID2021-126734OB-C21

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Área Teoría Señal y Comunicac. (Dpto. Ingeniería Electrón.Com.)