Schmidleitner, Christina and Arzt, Michael and Tafelmeier, Maria and Ripfel, Sarah and Fauser, Miriam and Weizenegger, Teresa and Floerchinger, Bernhard and Camboni, Daniele and Wittmann, Sigrid and Zeman, Florian and Schmid, Christof and Maier, Lars S. and Wagner, Stefan and Fisser, Christoph (2018) Sleep-disordered breathing is associated with disturbed cardiac repolarization in patients with a coronary artery bypass graft surgery. SLEEP MEDICINE, 42. pp. 13-20. ISSN 1389-9457, 1878-5506
Full text not available from this repository. (Request a copy)Abstract
Background: The development of malignant ventricular arrhythmias due to abnormal cardiac repolarization is a major complication after coronary artery bypass graft surgery (CABG). Sleep-disordered breathing (SDB) is linked to prolonged cardiac repolarization in non-surgical patients. This study evaluates cardiac repolarization in patients with and without SDB who underwent CABG. Methods: 100 patients who had received CABG (84% men, age 68 +/- 10 years, body-mass-index [BMI] 28.7 +/- 4.2 kg/m(2)) were retrospectively evaluated. Polygraphy was recorded the night before CABG. SDB was defined as an apnea-hypopnea index (AHI) of >= 15/h and differentiated into central (CSA) and obstructive (OSA) sleep apnea. Cardiac repolarizationwas assessed by means of T-peak-to-end (TpTe) and QTc-intervals and TpTe/QT-ratios derived from 12-lead electrocardiography (ECG). Results: 37% of patients had SDB, 14% CSA and 23% OSA. Before CABG, patients with CSA and OSA had longer TpTe intervals than those without SDB (TpTe: CSA 100 +/- 26 vs. OSA 97 +/- 19 vs. no SDB 85 +/- 14 ms, p = 0.013). QTc intervals and TpTe/QT ratios differed between the two groups (QTc: 444 +/- 54 vs. 462 +/- 36 vs. 421 +/- 32 ms, p < 0.001; TpTe/QT ratio: 0.24 +/- 0.04 vs. 0.23 +/- 0.05 vs. 0.21 +/- 0.03, p = 0.045). SDB was associated with abnormal cardiac repolarization independent of known risk factors for cardiac arrhythmias, such as age, sex, BMI, N-terminal-pro-brain-natriuretic-peptide (NT-proBNP), and heart failure (TpTe: B-coefficient [95%-CI]: 16.0, [7.6-24.3], p < 0.001; QTc: 27.2 [9.3-45.1], p = 0.003; TpTe/QT ratio: 2.9 [1.2-4.6], p < 0.001). Conclusion: Independent of known risk factors for cardiac arrhythmias, SDB was significantly associated with abnormal cardiac repolarization before CABG. Data suggest that SDB may contribute to an increased risk of ventricular arrhythmias after CABG. (c) 2018 Elsevier B.V. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ELEVATION MYOCARDIAL-INFARCTION; TP-E/QT RATIO; QT INTERVAL; HEART-FAILURE; PROGNOSTIC IMPLICATIONS; RECORDING DEVICE; APNEA; DISEASE; APNEALINK(TM); PREVALENCE; Sleep apnea; TpTe; QT; Cardiac repolarization; Cardiac arrhythmias; Coronary artery bypass graft surgery |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medicine > Lehrstuhl für Innere Medizin II Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 20 Mar 2020 12:15 |
| Last Modified: | 20 Mar 2020 12:15 |
| URI: | https://pred.uni-regensburg.de/id/eprint/15116 |
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