DYNAMICS OF QT/JT INTERVALS UNDER THE SHORT-TERM NON-INVASIVE POSITIVE AIRWAY PRESSURE THERAPY DURING SLEEP

To assess the QT/JT interval duration and blood pressure levels during short-term non-invasive positive airway pressure therapy, 25 patients with obesity, dyslipidemia, arterial hypertension, and obstructive sleep apnea-hypopnea syndrome were observed. To assess the QT/JT interval duration and dispersion, and the blood pressure level in the course of the short-term auto-titrating positive airway pressure therapy, 25 male subjects (mean age: 41 years) were assessed. All patients reported snore and had abdominal obesity, dyslipidemia, arterial hypertension, as well as moderate-to-severe sleep apnea-hypopnea syndrome. A 24 hour multifunctional study with cardiorespiratory monitoring was conducted in the study subjects before and in the course of therapy. The mean duration of auto-titrating treatment was 5 nights. During the treatment, decreased mean corrected QT interval for the wakefulness period (421 ms [412 436 ms] and 412 ms [404 431 ms]) and the sleep period (422 ms [407 437 ms] and 412 ms [402 427 ms]), as well as mean corrected JT interval for the wakefulness period (319 ms [306 330 ms] and 308 ms [296 320 ms]) and the sleep period (319 ms [303 335 ms] and 315 ms [299 329 ms]) were found (p<0.05 in all cases). There was no statistically significant difference in mean heart rate, non-corrected QT/JT intervals, and their dispersions. However, in 10 patients with an increased QT interval dispersion (>60 ms), it was found to be decreased on the average by 24.4% (p<0.05). A two-fold decrease in mean values of following sympathetic modulation markers: very low frequency (VLF) and low frequency (LF), was reported during sleep (p<0.05 in both cases). A threefold decrease in mean values of a parasympathetic tone indicator, the number of pairs of successive NNs that differ by more than 50 ms divided by the total number of all NN intervals (pNN50) was documented during sleep (p<0.05). The reduced duration of diastolic hypertension duration during the periods of sleep (by 22%) and wakefulness (by 10%), recovery of the diurnal pattern (n=8), and reduced mean values of systolic blood pressure (by 7 mm Hg) during sleep were registered in the course of treatment. Thus, a decreased sympathetic and parasympathetic effects on the heart rate, reduced duration of myocardial repolarization, decreased blood pressure, and recovery of its diurnal profile were observed during the short-term non-invasive positive airway pressure therapy during sleep.

QT/JT interval, heart rate variability, non-invasive positive airway pressure therapy, obstructive sleep apnea-hypopnea syndrome, arterial hypertension

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