Yıl: 2020 Cilt: 48 Sayı: 1 Sayfa Aralığı: 26 - 35 Metin Dili: İngilizce DOI: 10.5543/tkda.2019.66247

Implications of continuous positive airway pressure on heart rate variability in patients with obstructive sleep apnea: Does gender matter?

Öz:
Objective:This study was designed to determine the ef-fectiveness of continuous positive airway pressure (CPAP) treatment on the improvement of heart rate variability (HRV) and whether gender plays a role in HRV in patients with mode-rate to severe obstructive sleep apnea syndrome (OSAS).Methods:Consecutive patients with recently diagnosed moderate to severe OSAS underwent continuous synchro-nized electrocardiographic monitoring and were prospec-tively considered for inclusion in the study. HRV was ana-lyzed before starting CPAP therapy and 1 year thereafter. The effects of CPAP on HRV were evaluated in men and women separately to ascertain whether there are gender dif-ferences in the clinical manifestations of OSAS and whether female HRV responses to CPAP are similar to those of men.Results:A total of 18 patients (10 men, median age: 56 years) were included in the study. There were no signifi-cant differences in the baseline clinical characteristics of the male and female patients. After 1 year of CPAP treatment, heart rate decreased (p<0.05) and time domain parameters increased (p<0.05) in both men and women. None of the frequency domain parameters changed in women (p>0.05), whereas the high frequency power measured increased (p<0.05) and the ratio of low frequency to high frequency decreased (p<0.05) in men after 1 year of CPAP treatment. The increase in HRV after 1 year of CPAP therapy was sig-nificantly higher in men than in women (p<0.05).Conclusion:CPAP therapy reduced enhanced cardiac sympathetic nerve activity in patients with OSAS assessed according to HRV. The beneficial effect of long-term CPAP therapy on HRV was more pronounced in men.
Anahtar Kelime:

Obstrüktif uyku apneli hastalarda sürekli pozitif havayolu basıncı tedavisinin kalp hızı değişkenliği üzerine etkisi: Cinsiyetin önemi nedir?

Öz:
Amaç:Bu çalışmada, orta ve ciddi obstrüktif uyku apne sendromlu (OUAS) hastalarda sürekli pozitif hava yolu ba-sıncı (SPHB) tedavisinin kalp hızı değişkenliğini (KHD) iyi-leştirmedeki etkinliğini ve bu etkinlikte cinsiyetin rol oynayıp oynamadığını araştırmayı amaçladık. Yöntemler:Orta ve ciddi OUAS tanısı olan ve dışlama kri-terleri dışında kalan ardışık hastalar çalışmaya ileriye yö-nelik olarak dahil edilerek, sürekli senkronize elektrokardi-yografik inceleme yapıldı. SPHB tedavisine başlanmadan önce ve tedavi başlangıcından bir yıl sonraki sürede KHD analizi yapıldı. SPHB’nin, KHD üzerine olan etkilerinde cin-siyet farklılığı olup olmadığını incelemek ve SPHB yanıtının kadın ve erkeklerde farklı olup olmadığını analiz etmek için erkek ve kadınlarda ayrı ayrı değerlendirme yapıldı. Bulgular:Çalışmaya 18 hasta (10 erkek, ortanca yaş 56) dahil edildi. Erkek ve kadın hastalar arasında bazal klinik özellikler açısından anlamlı farklılık yoktu. Bir yıllık SPHB tedavisi sonrasında hem erkek hem kadınlarda; ortalama kalp hızının azaldığı (p<0.05), zaman temelli KHD para-metrelerinin arttığı (p<0.05) gözlendi. Bir yıllık tedavi son-rası kadınlarda frekans temelli KHD parametrelerinde bir değişiklik görülmezken (p>0.05); erkeklerde HF’de yüksel-me (p<0.05), LF/HF oranında düşme (p<0.05) saptandı. Ayrıca, bir yıllık SPHB tedavisinden sonra KHD’deki ar-tış, erkeklerde kadınlardan anlamlı olarak daha yüksekti (p<0.05). Sonuç:SPHB tedavisi OUAS hastalarında kardiyak sem-patik aktiviteyi azaltmakta ve KHD’yi arttırmaktadır. Uzun süreli SPHB tedavisinin bu faydalı etkileri erkeklerde daha belirgin olarak ortaya çıkmaktadır.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA ÖZLEK B, ÖZLEK E, DOĞAN V, BAŞARAN Ö, ÇİL C, ÇELİK O, BİTEKER M, BİLGE A (2020). Implications of continuous positive airway pressure on heart rate variability in patients with obstructive sleep apnea: Does gender matter?. Türk Kardiyoloji Derneği Arşivi, 48(1), 26 - 35. 10.5543/tkda.2019.66247
Chicago ÖZLEK Bülent,ÖZLEK Eda,DOĞAN Volkan,BAŞARAN Özcan,ÇİL Cem,ÇELİK Oğuzhan,BİTEKER Murat,BİLGE Ali Rıza Implications of continuous positive airway pressure on heart rate variability in patients with obstructive sleep apnea: Does gender matter?. Türk Kardiyoloji Derneği Arşivi 48, no.1 (2020): 26 - 35. 10.5543/tkda.2019.66247
MLA ÖZLEK Bülent,ÖZLEK Eda,DOĞAN Volkan,BAŞARAN Özcan,ÇİL Cem,ÇELİK Oğuzhan,BİTEKER Murat,BİLGE Ali Rıza Implications of continuous positive airway pressure on heart rate variability in patients with obstructive sleep apnea: Does gender matter?. Türk Kardiyoloji Derneği Arşivi, vol.48, no.1, 2020, ss.26 - 35. 10.5543/tkda.2019.66247
AMA ÖZLEK B,ÖZLEK E,DOĞAN V,BAŞARAN Ö,ÇİL C,ÇELİK O,BİTEKER M,BİLGE A Implications of continuous positive airway pressure on heart rate variability in patients with obstructive sleep apnea: Does gender matter?. Türk Kardiyoloji Derneği Arşivi. 2020; 48(1): 26 - 35. 10.5543/tkda.2019.66247
Vancouver ÖZLEK B,ÖZLEK E,DOĞAN V,BAŞARAN Ö,ÇİL C,ÇELİK O,BİTEKER M,BİLGE A Implications of continuous positive airway pressure on heart rate variability in patients with obstructive sleep apnea: Does gender matter?. Türk Kardiyoloji Derneği Arşivi. 2020; 48(1): 26 - 35. 10.5543/tkda.2019.66247
IEEE ÖZLEK B,ÖZLEK E,DOĞAN V,BAŞARAN Ö,ÇİL C,ÇELİK O,BİTEKER M,BİLGE A "Implications of continuous positive airway pressure on heart rate variability in patients with obstructive sleep apnea: Does gender matter?." Türk Kardiyoloji Derneği Arşivi, 48, ss.26 - 35, 2020. 10.5543/tkda.2019.66247
ISNAD ÖZLEK, Bülent vd. "Implications of continuous positive airway pressure on heart rate variability in patients with obstructive sleep apnea: Does gender matter?". Türk Kardiyoloji Derneği Arşivi 48/1 (2020), 26-35. https://doi.org/10.5543/tkda.2019.66247