Association of electrocardiogram features with risk of obstructed sleep apnea: a population-based cohort study.

IF 2 4区医学 Q3 CLINICAL NEUROLOGY Sleep and Breathing Pub Date : 2025-02-11 DOI:10.1007/s11325-025-03266-7

Chuchu Wu, Jun Huang, Minjing Huang, Yiting Tan, Chuanjiang Chen, Murui Zheng, Wenjing Zhao, Yangjie Xu, Lili Guo, Xiuyi Wu, Yumei Xue, Hai Deng, Xudong Liu

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Abstract

Background: There is limited investigation on the longitudinal association between common electrocardiogram (ECG) features and the incidence of obstructive sleep apnea (OSA). This study aimed to examine the association of common ECG features with the incidence of OSA in a prospective cohort.

Methods: 2,563 participants aged 60 years or more were selected from the baseline survey of the Guangzhou Heart Study. OSA was evaluated by the Berlin Questionnaire. Eight electrocardiogram features including PR interval, QRS duration, QT interval, QTc interval, heart rate, P-wave, R-wave, and T-wave were extracted from 24-hour single-lead Holter. Relative risk (RR) with 95% confidence interval (CI) was estimated using the multivariate logistic regression model. A receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive ability of ECG features.

Results: 397 (15.5%) participants were divided into the OSA group and 2,166 (84.5%) into the OSA non-group. When comparing the highest with the lowest quartiles, heart rate was related to a 30% reduced risk of OSA (RR: 0.70, 95%CI: 0.51-0.97) after adjustment for possible confounders. Participants with prolonged PR interval were more likely to be at risk of OSA (RR: 2.68, 95%CI: 1.02-6.55). No significant association was found between the other six ECG features and OSA risk. Area under ROC curve was 0.676 (95% CI: 0.648-0.704), 0.676 (95%CI: 0.648-0.704), and 0.678 (95%CI: 0.651-0.706) for heart rate, PR interval, and their combination, respectively.

Conclusions: The results suggest that heart rate and PR interval are related to OSA incidence. Future studies should be carried out in different populations, and consider the use of portable monitors together with scales to comprehensively determine OSA, and comprehensively elucidate the relationship of various ECG features and their changes with OSA occurrence.

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心电图特征与阻塞性睡眠呼吸暂停风险的关联：一项基于人群的队列研究。

背景：常见心电图（ECG）特征与阻塞性睡眠呼吸暂停（OSA）发生率之间的纵向关联研究有限。本研究旨在通过前瞻性队列研究常见心电图特征与OSA发病率的关系。方法：从广州心脏研究的基线调查中选择2563名60岁或以上的参与者。采用柏林问卷评估OSA。从24小时单导联动态心电图中提取PR间期、QRS持续时间、QT间期、QTc间期、心率、p波、r波、t波等8项心电图特征。采用多变量logistic回归模型估计相对危险度（RR）， 95%置信区间（CI）。采用受试者工作特征（ROC）曲线分析评价心电图特征的预测能力。结果：397人（15.5%）被分为OSA组，2166人（84.5%）被分为非OSA组。当将最高四分位数与最低四分位数进行比较时，校正可能的混杂因素后，心率与OSA风险降低30%相关（RR: 0.70, 95%CI: 0.51-0.97）。PR间期延长的受试者更容易发生OSA （RR: 2.68, 95%CI: 1.02-6.55）。其他6项心电图特征与OSA风险无明显关联。心率、PR间期及其组合的ROC曲线下面积分别为0.676 （95%CI: 0.648-0.704）、0.676 （95%CI: 0.648-0.704）和0.678 （95%CI: 0.651-0.706）。结论：心率和PR间期与OSA的发生有关。今后的研究应在不同人群中开展，并考虑使用便携式监护仪结合体表综合判断OSA，全面阐明各种心电图特征及其变化与OSA发生的关系。

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来源期刊

Sleep and Breathing 医学-呼吸系统

CiteScore

5.20

自引率

4.00%

发文量

222

审稿时长

3-8 weeks

期刊介绍： The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep. Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.