Correlation between apnea-hypopnea index and Tp-Te interval, Tp-Te/QT, and Tp-Te/QTc ratios in obstructive sleep apnea

Abstract

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) = 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.