Background
Hypertrophic cardiomyopathy (HCM) is associated with arrhythmias and cardiovascular
death. Obstructive sleep apnea (OSA) is highly prevalent and independently associated
with atrial fibrillation in patients with HCM.
Objective
The purpose of this study was to determine the relationship between nonsustained ventricular
tachycardia (NSVT) and OSA in hypertrophic obstructive cardiomyopathy (HOCM).
Methods
One hundred thirty consecutive patients with a confirmed diagnosis of HOCM in Fuwai
Hospital between September 2017 and May 2018 were included. Polysomnography and Holter
electrocardiography were performed in all patients.
Results
Of 130 patients, 72 (55%) were diagnosed with OSA, including 38 with mild, 21 with
moderate, and 13 with severe OSA, and 27 patients (21%) had NSVT. The prevalence of
NSVT increased with the severity of OSA (none, mild, moderate, and severe: 12%, 16%,
33%, and 54%, respectively; P < .001 for trend). Compared to patients without NSVT, the apnea-hypopnea index was
significantly higher in patients with NSVT among the different OSA groups (mild, moderate,
and severe: 12 [11–13] vs 7 [6–8], P = .001; 24 [22–28] vs 19 [17–22], P = .01; and 54 [41–62] vs 34 [31–39], P = .008). In multivariate logistic regression analysis, family history of HCM or sudden
cardiac death (odds ratio 6; 95% confidence interval 2–22; P = .005) and apnea-hypopnea index (odds ratio 1.07; 95% confidence interval 1.02-1.12;
P = .001) were the only factors associated with NSVT after adjustment for age, sex,
and body mass index.
Conclusion
The presence and severity of OSA in patients with HOCM is independently associated
with NSVT, which is a risk factor for sudden cardiac death and cardiovascular death
in this population.
Keywords
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Article info
Publication history
Published online: December 18, 2018
Footnotes
This work was supported by the National Natural Science Foundation of China (grant no. 81570276).
Identification
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