title: Arrhythmogenic Substrates in Sleep-Disordered Breathing with Arterial Hypertension.
abstract: BACKGROUND
  Sleep-disordered breathing (SDB) is highly associated with arterial hypertension (HT). Sympathetic hypertonia increases the risk of sudden cardiac death in patients with sleep apnea. This study aims to noninvasively investigate the electrophysiological features in SDB patients with and without arterial HT.
  
  
  METHODS
  Fifty-three patients with SDB were classified into two groups: SDB group and SDB + HT group. Twenty subjects with arterial HT were enrolled as controls (HT group). To assess arrhythmogenic vulnerability, high-resolution 24-hour ambulatory electrocardiograms were obtained for analyzing continuous late potential (LP), T-wave amplitude variability (TAV), and heart rate variability (HRV).
  
  
  RESULTS
  A higher incidence of positive LP was observed in the SDB + HT (85%) group than that observed in the SDB (50%) and HT (20%) groups (P < 0.01). TAV was highest in the SDB + HT group (78 μV) compared with the SDB (61 μV) and HT groups (42 μV; P < 0.01). Positive LP and TAV values were observed at night in the SDB + HT and SDB groups. The low-frequency/high-frequency of the HRV analysis was highest in the SDB + HT (4.7) group compared with that in the SDB (2.9) and HT (2.9) groups (P = 0.01).
  
  
  CONCLUSIONS
  Nocturnal LP, TAV, and HRV examinations were useful to investigate arrhythmogenesis. SDB patients with arterial HT showed a high prevalence of depolarization and repolarization abnormalities and relative sympathetic hyperactivity. This suggests that an electrophysiological instability is more prevalent in SDB patients with arterial HT.
authors.affiliation: Department of Cardiovascular Medicine, Tokai University School of Medicine, Isehara, Japan.
authors.forename: Mari
authors.initials: M
authors.lastname: Amino
authors.affiliation: Department of Cardiovascular Medicine, Tokai University School of Medicine, Isehara, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Yoshioka
authors.affiliation: Department of Respiratory Medicine, Tokai University School of Medicine, Isehara, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Aoki
authors.affiliation: Clinical Laboratory Center, Tokai University School of Medicine, Isehara, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Clinical Laboratory Center, Tokai University School of Medicine, Isehara, Japan.
authors.forename: Tomiei
authors.initials: T
authors.lastname: Iga
authors.affiliation: Department of Cardiovascular Medicine, Tokai University School of Medicine, Isehara, Japan.
authors.forename: Shigetaka
authors.initials: S
authors.lastname: Kanda
authors.affiliation: Duet Internal Medicine Clinic, Saitama, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Abe
authors.affiliation: Department of Emergency Critical Care Medicine, Tokai University School of Medicine, Isehara, Japan.
authors.forename: Sadaki
authors.initials: S
authors.lastname: Inokuchi
authors.affiliation: Ebina General Hospital Cardiovascular Center, Ebina, Japan.
authors.forename: Teruhisa
authors.initials: T
authors.lastname: Tanabe
authors.affiliation: Department of Cardiovascular Medicine, Tokai University School of Medicine, Isehara, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ikari
mesh_terms: D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000453:epidemiology*; D015984:Causality; D015897:Comorbidity; D015716:Electrocardiography, Ambulatory / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology*; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017286:Polysomnography / Q000706:statistics & numerical data; D011379:Prognosis; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology*
keywords: T-wave amplitude variability; ambulatory electrocardiogram; late potential; sleep-disordered breathing