Effect of Nocturnal Intermittent Hypoxia on Left Atrial Appendage Flow Velocity in Atrial Fibrillation

Takehiro Kimura, Takashi Kohno, Kazuaki Nakajima, Shin Kashimura, Yoshinori Katsumata, Takahiko Nishiyama, Nobuhiro Nishiyama, Yoko Tanimoto, Yoshiyasu Aizawa, Keiichi Fukuda, Seiji Takatsuki

研究成果: Article査読

4 被引用数 (Scopus)

抄録

Background: The mechanism underlying the associations of sleep-disordered breathing (SDB) with stroke and atrial fibrillation (AF) is not well established. We explored the relationship between nocturnal intermittent hypoxia, a marker of SDB, and left atrial (LA)/LA appendage (LAA) function among AF patients. Methods: We evaluated 134 consecutive AF candidates for catheter ablation (age, 59.6 ± 9.4 years; body mass index [BMI], 24.8 ± 3.2; Congestive Heart Failure, Hypertension, Age (≥75 years), Diabetes, Stroke/Transient Ischemic Attack, Vascular Disease, Age (65-74 years), Sex (Female) (CHA2DS2-VASc) score, 1.2 ± 1.1, paroxysmal AF, n = 83) using nocturnal pulse oximetry, a noninvasive screening method for nocturnal intermittent hypoxia. Based on 3% oxygen desaturation index (3% ODI), patients were divided into nocturnal intermittent hypoxia (3% ODI > 15; n = 32) and control groups (3% ODI ≤ 15; n = 102). Results: The nocturnal intermittent hypoxia group demonstrated significantly higher weight, BMI, Congestive Heart Failure, Hypertension, Age, Diabetes, Stroke/Transient Ischemic Attack (CHADS2) and CHA2DS2-VASc scores, serum hemoglobin A1c and plasma brain natriuretic peptide levels, LA size, and prevalence of hypertension, vascular disease, and sick sinus syndrome. Echocardiographically, nocturnal intermittent hypoxia was associated with a higher grade of spontaneous echo contrast and low LAA flow velocity. Multiple regression analysis adjusted for type of AF, CHA2DS2-VASc score, BMI, plasma brain natriuretic peptide level, LA size, and rhythm on echocardiography revealed that 3% ODI was a factor independently associated with LAA flow velocity (β = -0.184; 95% confidence interval, -0.818 to -0.006). Conclusions: Nocturnal intermittent hypoxia was an independent determinant for low LAA flow velocity in patients with AF, suggesting that the connection between SDB and LAA function might underlie the association of AF with stroke.

本文言語English
ページ(範囲)846-852
ページ数7
ジャーナルCanadian Journal of Cardiology
31
7
DOI
出版ステータスPublished - 2015 7 1

ASJC Scopus subject areas

  • 循環器および心血管医学

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