Effect of CPAP on QT interval dispersion in obstructive sleep apnea patients without hypertension

• Published in: Sleep medicine Vol. 8; no. 5; pp. 478 - 483
• Main Authors: Dursunoglu, Dursun, Dursunoglu, Nese
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01-08-2007
• Subjects: Adult; Body Mass Index; Continuous Positive Airway Pressure - methods; CPAP therapy; Female; Humans; Hypertension - complications; Hypertension - diagnosis; Long QT Syndrome - etiology; Long QT Syndrome - prevention & control; Male; Middle Aged; Neurology; Obstructive sleep apnea; Polysomnography - methods; QT interval dispersion; Severity of Illness Index; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - therapy; Sleep Medicine; Treatment Outcome; Obstructive sleep apnea; CPAP therapy; QT interval dispersion
• ISSN: 1389-9457; 1878-5506
• DOI: 10.1016/j.sleep.2006.08.002

Abstract Objectives Delayed cardiac repolarization leading to prolongation of the QT interval is a well-characterised precursor of arrhythmias. Obstructive sleep apnea (OSA) might cause arryhthmias, since QT corrected interval dispersion (QTcd) is increased in these patients. We aimed to determine the effect of nasal continuous positive airway pressure (CPAP) therapy on QTcd in OSA patients without hypertension. Methods An overnight polysomnography (PSG) and a standard 12-lead electrocardiogram (ECG) were performed on 49 subjects without hypertension, diabetes mellitus, cardiac or pulmonary disease or any hormonal, hepatic, renal or electrolyte disorders. In 29 moderate-severe OSA (apnea–hypopnea index: AHI ⩾ 15) patients, QTd (defined as the difference between the maximum and minimum QT interval) and QTcd were calculated using the Bazzet formula at baseline and after six months of CPAP therapy. Results Eighteen patients were compliant with nasal CPAP, and mean age was 46.5 ± 4.9 years. Patients had high body mass index (BMI: 30.6 ± 4.0 kg/m2 ), but there was no change in either BMI or blood pressure after six months. A strong positive correlation was shown between QTcd and AHI ( p < 0.001, r = 0.913). The QTcd at baseline (54.5 ± 8.7 ms) significantly decreased after CPAP therapy (35.5 ± 4.2 ms, p < 0.001), although it did not significantly change in 11 non-compliant patients. Conclusion In OSA patients without hypertension, CPAP therapy improves the inhomogeneity of repolarization via a significant decrease in QTcd.