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Sleep-disordered breathing is associated with ventricular arrhythmias in postmenopausal women with hypertension and coronary artery disease.

Session Poster Session 1

Speaker Valentina Tsareva

Congress : Heart Failure 2019

  • Topic : basic science
  • Sub-topic : Basic Science - Cardiac Diseases: Arrhythmias
  • Session type : Poster Session
  • FP Number : P632

Authors : V Tsareva (Smolensk,RU), N Novitskii (Kaluga,RU), K Sundukova (Smolensk,RU)

Authors:
V Tsareva1 , N Novitskii2 , K Sundukova3 , 1Smolensk State Medical University, Therapy, ultrasound and functional diagnostics - Smolensk - Russian Federation , 2City Clinical Hospital 2 - Kaluga - Russian Federation , 3Smolensk State Medical University, Research center - Smolensk - Russian Federation ,

Citation:

Background: Arterial hypertension (AH) and coronary artery disease (CAD) hold leading position in the structure of cardiovascular morbidity. High risk of developing AH and CAD becomes clinically significant after a woman enters menopause. The problem of sleep-disordered breathing is also being actively studied recently, as more and more information is accumulating about the negative effect of sleep apnea on the cardiovascular system. 
Purpose: To study the role of sleep-disordered breathing on ventricular arrhythmias (VA) in postmenopausal women with AH and CAD
Methods: 144 postmenopausal women with AH 1–2 degrees and chronic forms of CAD (mean age 66.6 ± 7.5 years) were examined. 27.1% of women had heart failure (NYHA I-II). The first group included 96 patients with VA. The second group consisted of 48 women without VA. The groups were divided into subgroups: A - index of apnea / hypopnea (AHI) <5 per hour of sleep; B - AHI = 5 per hour of sleep. Patients underwent holter monitoring of ECG and respiratory monitoring.To characterize the VA, the Lown and Wolf classification was used in the Ryan modification. VA 3 and higher gradations were taken to arrhythmias of high gradations.
Results: Patients with sleep-disordered breathing (AHI = 5 per hour of sleep) were found in the I (36.5%) and II (22.9%) groups, but in the group with VA of such patients there was a 13.6% increase (?² with the Yates correction = 1.9 p> 0.05). Patient didn’t significantly differ in the frequency of detection of VA I, III, IV? and V grades (?> 0.05). Frequent ventricular extrasystole (VE) by 22.2% (p <0.01 in the Fisher test) was more often recorded in patients in the IA subgroup (29.9% and 5.7% accordingly). Polymorphic pair VE more often (by 20.8%; p <0.01 by Fisher test) was detected in women of the IB subgroup. In patients with IB subgroups, arrhythmias of high gradations (51.4%) were more frequent (21.9% ?² = 4.56 p <0.05) compared with the IA subgroup.Using the method of calculating the odds ratio, it was found that the AHI = 5 episodes per hour of sleep increases the chance of development of high-grade VA by 2.5 times, polymorphic pair VE by 7 times.
Conclusions:Sleep-disordered breathing (AHI = 5 per hour of sleep) is associated with high-gradation VA and polymorphic paired VE.

Indicator

index of apnea / hypopnea

OR

95% CI

P criteria χ²

High gradations ventricular arrhythmias

2,52

1,16 - 5,92

<0,05

Polymorphic pair ventricular extrasystole

7,0

1,75 - 28,22

<0,01

OR - odds ratio; CI - confidence interval


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