Source: Annual Congress 2010 - Nocturnal cardiology: chronic heart failure, acute chest syndrome, coronary artery disease and collagen vascular disease
Disease area: Pulmonary vascular diseases, Sleep and breathing disorders

Abstract

Aims: Changes in heart rate variability (HRV) and blood pressure (BP) reflecting sympatho-vagal balance, were tested for screening of life-threatening cardiovascular risk in sleep disordered breathing (SDB).
Methods: Both HRV and BP parameters obtained by ambulatory monitoring using CardioTense, Meditech, were analyzed in 43 adults. SDB characterized by apnoea/hypopnoea index (AHI>5/h), detected by parallel polysomnography (Alice3, Respironics), were compared to essential hypertension and controls. Low and high frequency (LF, HF) bands, LF/HF ratio and various BP values were analyzed in the three groups.
Results: The day-time values of LF band (5.97±1.1 logms²) and systolic BP (137.4±13.4 mmHg) in SDB were lower than in essential hypertension (6.7±0.6 logms² and 150, 6±22.8 mmHg, p<0.05), but diastolic (84.8±9.1 mmHg) and other BPs were higher compared to controls (p<0.05-0,001), indicating secondary hypertension. Nocturnal values of both the LF (6.70±1.14 logms²) and HF (5.79±1.20 logms²) bands were higher than their day-time values (p<0.05), documenting strong perturbations of sympatho-vagal balance during sleep. Correlation of nocturnal values of LF band (r=0.2307, p=0.013), LF/HF ratio (r=0.2906, p=0.045) and DBP with AHI (r=0.1514, p=0.049) indicate association with apnoeic episodes, causing hypoxemia and arousals in SDB.
Conclusion: There are strong perturbations of sympatho-vagal balance in SDB during sleep, persisting partly for wakefulness and correlation of nocturnal values of LF band, LF/HF ratio and DBP with AHI. They justify usefulness of HRV and BP analysis for screening cardiovascular risks in SDB and their modifications (Tomori, Z, et al.: J Physiol Pharmacol 2010;61(1).

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Citations should be made in the following way:
S. Gresova, Z. Tomori, V. Donic, M. Kundrik, J. Stimmelova, I. Bacova, B. Fulton (Kosice, Košice, Slovakia). Cardiovascular risk in sleep apnoea: Heart rate variability and blood pressure analysis. Eur Respir J 2010; 36: Suppl. 54, 906

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