Intermittent hypoxia by obstructive sleep apnea is significantly associated with electro-anatomical remodeling of the left atrium preceding structural remodeling in patients with atrial fibrillation.

Autor:	Takada Y; Department of Cardiology, Tokyo Medical University, Japan., Shiina K; Department of Cardiology, Tokyo Medical University, Japan., Orihara S; Department of Health Data Science, Tokyo Medical University, Japan., Takata Y; Department of Cardiology, Tokyo Medical University, Japan., Takahashi T; Department of Cardiology, Tokyo Medical University, Japan., Kani J; Department of Cardiology, Tokyo Medical University, Japan., Kusume T; Department of Cardiology, Tokyo Medical University, Japan., Terasawa M; Department of Cardiology, Tokyo Medical University, Japan., Nakano H; Department of Cardiology, Tokyo Medical University, Japan., Saitoh Y; Department of Cardiology, Tokyo Medical University, Japan., Yazaki Y; Department of Cardiology, Tokyo Medical University, Japan., Tomiyama H; Department of Cardiology, Tokyo Medical University, Japan., Chikamori T; Department of Cardiology, Tokyo Medical University, Japan., Satomi K; Department of Cardiology, Tokyo Medical University, Japan.
Jazyk:	angličtina
Zdroj:	International journal of cardiology. Heart & vasculature [Int J Cardiol Heart Vasc] 2024 Aug 13; Vol. 54, pp. 101490. Date of Electronic Publication: 2024 Aug 13 (Print Publication: 2024).
DOI:	10.1016/j.ijcha.2024.101490
Abstrakt:	Background: Obstructive sleep apnea (OSA) is one of the risk factors for atrial fibrillation (AF). However, the mechanism underlying the atrial structural and electro-anatomical remodeling by OSA has not yet been clearly elucidated. Methods: This study was conducted in 83 patients who had undergone catheter ablation for AF (49 with OSA and 34 Controls without OSA). The left atrial (LA) maps were created in all the patients using a three-dimensional electro-anatomical mapping system. The LA with a bipolar voltage of <0.5 mV was defined as the low voltage area (LVA); %LVA was defined as the ratio of the LVA to the total surface area of the LA. Results: The LVA and %LVA were significantly greater in the OSA group as compared with the Control group, however, there was no difference in the LA area. The 3 % oxygen desaturation index (ODI) was significantly correlated with the %LVA (r = 0.268, P = 0.014), but not with the LA area. Multiple regression analysis with adjustments identified 3 %ODI ≥30 (3.088, 1.078-8.851, P = 0.036) as being significantly associated with the %LVA. Conclusions: In patients with AF complicated by OSA, significant increase of the LVA, but not of the LA area, was observed. The intermittent hypoxia severity was significantly associated with the LVA. These results suggest that intermittent hypoxia by OSA might be one of the mechanisms of electro-anatomical remodeling of the LA, possibly preceding structural remodeling represented by LA enlargement, in patients with AF. Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2024 The Author(s).)
Databáze:	MEDLINE
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