russjcardiolРоссийский кардиологический журналRussian Journal of Cardiology1560-40712618-7620«SILICEA-POLIGRAF» LLC10.15829/1560-4071-2024-5777OGFKQPrussjcardiol-5777Research ArticleОЦЕНКА РИСКАСравнительная характеристика пациентов с сочетанием обструктивного апноэ сна и пароксизмальной формой фибрилляции предсердий в группах интервенционного и медикаментозного лечения аритмииComparative characteristics of patients with a combination of obstructive sleep apnea and paroxysmal atrial fibrillation in the groups of interventional and conservative treatment of arrhythmiahttps://orcid.org/0000-0003-4580-8292ОбуховаН. Т.ObukhovaN. T.

Надежда Тимофеевна Обухова — врач-кардиолог.

Москва

Moscow

nadyaobukhova@gmail.comhttps://orcid.org/0000-0002-4982-628XАгальцовМ. В.AgaltsovM. V.

Михаил Викторович Агальцов — к. м. н., с. н. с.

Москва

Moscow

agaltsov@rambler.ruhttps://orcid.org/0000-0002-4453-8430ДрапкинаО. М.DrapkinaO. M.

Оксана Михайловна Драпкина — д. м. н., профессор, академик РАН, директор.

Москва

Moscow

drapkina@bk.ruФГБУ Национальный медицинский исследовательский центр терапии и профилактической медицины Минздрава РоссииРоссияNational Medical Research Center for Therapy and Preventive MedicineRussian Federation20242608202429757775777Copyright © Обухова Н.Т., Агальцов М.В., Драпкина О.М., 20242024Обухова Н.Т., Агальцов М.В., Драпкина О.М.Obukhova N.T., Agaltsov M.V., Drapkina O.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://russjcardiol.elpub.ru/jour/article/view/5777Цель

Цель. Сравнить особенности клинических характеристик двух групп пациентов с сочетанием обструктивного апноэ сна (ОАС) и пароксизмальной формы фибрилляции предсердий (ФП), находящихся на консервативной терапии аритмии и после катетерной аблации устьев легочных вен.

Материал и методы

Материал и методы. В исследование включено 362 пациента с пароксизмальной формой ФП, которым проведено респираторное мониторирование сна.

Результаты

Результаты. Выявлено преобладание ОАС клинически значимых степеней (средние и тяжелые — 37% и 29%, соответственно), а также более высокая лекарственная нагрузка и коморбидность в группе пациентов медикаментозного лечения ФП. Пороговое значение индекса массы тела (ИМТ), при котором прогнозировался высокий риск ОАС тяжелой степени, соответствовало наличию ожирения 1 степени (ИМТ ≥31 кг/м2). Полученные результаты продемонстрировали наличие ассоциации между увеличением переднезаднего размера левого предсердия и степенью тяжести ОАС (4,1 [3,8-4,4] см, r=0,28; р<0,001), которые могут быть обусловлены структурным ремоделированием сердца у пациентов с сочетанием пароксизмальной формы ФП и тяжелыми формами ОАС.

Заключение

Заключение. В когорте пациентов с пароксизмальной формой ФП выявлена высокая частота встречаемости ОАС клинически значимых степеней. В группе пациентов с сочетанием ОАС и ФП, находящихся на консервативном лечении, выявлены более неблагоприятные характеристики сердечно-сосудистой системы, большая коморбидная нагрузка по сравнению с группой пациентов, прошедших оперативное лечение.

Aim

Aim. To compare the clinical characteristics of two groups of patients with a combination of obstructive sleep apnea (OSA) and paroxysmal atrial fibrillation (AF), undergoing conservative treatment for arrhythmia and after pulmonary vein isolation.

Material and methods

Material and methods. The study included 362 patients with paroxysmal AF who underwent respiratory sleep monitoring.

Results

Results. A predominance of clinically significant OSA was revealed (moderate and severe — 37% and 29%, respectively), as well as a higher drug burden and comorbidity in the group of patients receiving drug treatment for AF. The threshold value of body mass index (BMI), at which a high risk of severe OSA was predicted, corresponded to class 1 obesity (BMI ≥31 kg/m2). The results obtained demonstrated an association between an increase in the left atrium anteroposterior size and the severity of OSA (4,1 [3,8-4,4] cm, r=0,28; p<0,001), which may be due to cardiac structural remodeling in patients with a combination of paroxysmal AF and severe OSA.

Conclusion

Conclusion. In a cohort of patients with paroxysmal AF, a high incidence of clinically significant OSA was revealed. In the group of patients with a combination of OSA and AF undergoing conservative treatment, more unfavorable cardiovascular characteristics and a more severe comorbid status were revealed compared to the group of patients undergoing surgical treatment.

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The authors declare that there are no conflicts of interest present.