Key result
Prolonged Tp-Te interval in obstructive sleep apnea predicts ~63% higher odds of severe AHI.
Why the study?
OSA is linked to ventricular arrhythmias, but the correlation between the apnea-hypopnea index and ventricular repolarization indices (Tp-Te, Tp-Te/QT, and Tp-Te/QTc) required investigation.
Do ventricular repolarization indices (Tp-Te, Tp-Te/QT, Tp-Te/QTc) correlate with the severity of obstructive sleep apnea?
Observational (n=280)
No
Do ventricular repolarization indices (Tp-Te, Tp-Te/QT, Tp-Te/QTc) correlate with the severity of obstructive sleep apnea?
Effect estimate: OR 1.629 (95% CI 1.393-1.906)
p-value: p=<.001
Ventricular repolarization parameters (Tp-Te, Tp-Te/QT, Tp-Te/QTc) are significantly prolonged in patients with obstructive sleep apnea and correlate with disease severity, suggesting a potential mechanism for increased arrhythmogenic risk.
BACKGROUND: Obstructive sleep apnea (OSA) is a highly prevalent sleep disorder associated with important cardiovascular complications including ventricular arrhythmias. Tp-Te interval, Tp-Te/QT, and Tp-Te/QTc ratios are repolarization indices representing ventricular arrhythmogenic potential. These parameters are associated with ventricular arrhythmias and sudden cardiac death. The aim of this study was to investigate the correlation between apnea-hypopnea index and Tp-Te, Tp-Te/QT, and Tp-Te/QTc in OSA. METHODS: We screened a total of 280 patients who underwent overnight polysomnography (PSG) between the years 2012-2017 at our institution. Patients were assigned into four groups based on severity of apnea-hypopnea index: 70 with apnea-hypopnea index (AHI) <5 (control group), 71 with 5 ≤ AHI < 15, 63 with 15 ≤ AHI < 30, and 76 with AHI ≥ 30. Tp-Te, Tp-Te/QT, and Tp-Te/QTc were measured. RESULTS: Compared to control group, repolarization parameters were significantly prolonged in other groups (Tp-Te interval: 68.3 ± 6.8, 71.8 ± 6.3, 79.1 ± 5.5, and 85.1 ± 6.4 ms, p < .001; Tp-Te/QT ratio: 167.5 ± 12.7, 181.7 ± 13.0, 202.2 ± 10.0 and 219.4 ± 13.5, p < .001; Tp-Te/QTc ratio: 151.1 ± 16.6, 167.6 ± 16.6, 193.7 ± 14.4, and 225.5 ± 17.0, p < .001). There was a significant trend toward higher Tp-Te, Tp-Te/QT, and Tp-Te/QTc across higher AHI categories. In a univariate regression analysis, body mass index, smoking status, Tp-Te, and Tp-Te/QTc were significantly associated with the severity of AHI in OSA. Tp-Te (OR 1.629, 95% CI 1.393-1.906, p < .001), Tp-Te/QTc (OR 1,333 95% CI 1.247-1.424, p < .001), and smoking status (OR 5.771, 95% CI 1.025-32.479, p = .047) were found to be significant independent predictors of severity of AHI in a multivariate analysis, after adjusting for other risk parameters. CONCLUSIONS: Our study showed that Tp-Te, Tp-Te/QT, and Tp-Te/QTc were prolonged in patients with OSA. There was significant correlation between apnea-hypopnea index and these parameters.
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Karaçöp et al. (2020) conducted an observational in Obstructive sleep apnea (n=280). Obstructive sleep apnea (AHI ≥ 5) vs. Control group (AHI < 5) was evaluated on Tp-Te interval, Tp-Te/QT, and Tp-Te/QTc ratios (OR 1.629, 95% CI 1.393-1.906, p=<.001). Ventricular repolarization parameters, including Tp-Te interval, were significantly prolonged in obstructive sleep apnea and independently predicted apnea-hypopnea index severity (OR 1.629; 95% CI 1.393-1.906; p<0.001).
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