Patients with obstructive sleep apnea syndrome had a significantly higher frequency of fragmented QRS complexes compared to controls (61% vs. 35%, p=0.021).
Case-Control (n=85)
Single-blind
No
Patients with obstructive sleep apnea syndrome exhibit a significantly higher frequency of fragmented QRS complexes and prolonged QRS durations, suggesting subclinical myocardial changes that may be linked to increased cardiovascular risk.
Effect estimate: OR 2.842 (95% CI 1.155-6.992)
Absolute Event Rate: 61% vs 35%
p-value: p=0.021
BACKGROUND: Obstructive sleep apnea syndrome (OSAS) is a disease with increasing prevalence, which is mainly characterized by increased cardiopulmonary mortality and morbidity. It is well-known that OSAS patients have increased prevalence of cardiovascular diseases including coronary heart disease, heart failure, and arrhythmias. The aim of this study was to evaluate the presence of prolonged and fragmented QRS complexes, which have previously been associated with cardiovascular mortality, in OSAS patients. METHODS: Our study included 51 patients (mean age 41.6 ± 10.1 years) who were recently diagnosed with OSAS (apnea-hypopnea index AHI ≥5 events/h) and never received therapy. The control group consisted of 34 volunteers (mean age 43.1 ± 11.6 years) in whom OSAS was excluded (AHI <5 events/h). The longest QRS complexes was measured in the 12-lead electrocardiogram (ECG) and the presence of fragmentation in QRS complexes was investigated. RESULTS: Fragmented QRS frequency was significantly higher in patients with OSAS (n = 31 61% vs. n = 12 35%, P = 0.021). QRS and QTc durations were also significantly longer in OSAS patients than controls (99.8 ± 13.9 ms vs. 84.7 ± 14.3 ms, P < 0.001; 411.4 ± 26.9 ms vs. 390.1 ± 32.2 ms, P = 0.001, respectively). Analysis of the patient and controls groups combined revealed a weak-moderate correlation between AHI and QRS duration (r = 0.292, P = 0.070). OSAS group had no correlation between AHI and QRS duration (r = -0.231, P = 0.203). CONCLUSIONS: In our study fragmented QRS frequency and QRS duration were found to increase in OSAS patients. Both parameters are related with increased cardiovascular mortality. Considering the prognostic importance of ECG parameters, it may be reasonable to recommend more detailed evaluation of OSAS patients with fragmented or prolonged QRS complexes with respect to presence of cardiovascular diseases.
Sayın et al. (Mon,) conducted a case-control in Obstructive Sleep Apnea Syndrome (n=85). Obstructive Sleep Apnea Syndrome vs. No OSAS (AHI <5 events/h) was evaluated on Fragmented QRS frequency (OR 2.842, 95% CI 1.155-6.992, p=0.021). Patients with obstructive sleep apnea syndrome had a significantly higher frequency of fragmented QRS complexes compared to controls (61% vs. 35%, p=0.021).