Effect of Nocturnal Intermittent Hypoxia on Left Atrial Appendage Flow Velocity in Atrial Fibrillation
Abstract Background The mechanism underlying the associations of sleep-disordered breathing (SDB) with stroke and atrial fibrillation (AF) is not well established. We explored the relationship between nocturnal intermittent hypoxia, a marker of SDB, and left atrial (LA)/LA appendage (LAA) function a...
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| Veröffentlicht in: | Canadian journal of cardiology 2015-07, Vol.31 (7), p.846-852 |
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| creator | Kimura, Takehiro, MD, PhD Kohno, Takashi, MD, PhD Nakajima, Kazuaki, MD Kashimura, Shin, MD Katsumata, Yoshinori, MD, PhD Nishiyama, Takahiko, MD, PhD Nishiyama, Nobuhiro, MD, PhD Tanimoto, Yoko, MD, PhD Aizawa, Yoshiyasu, MD, PhD Fukuda, Keiichi, MD, PhD Takatsuki, Seiji, MD, PhD |
| description | Abstract Background The mechanism underlying the associations of sleep-disordered breathing (SDB) with stroke and atrial fibrillation (AF) is not well established. We explored the relationship between nocturnal intermittent hypoxia, a marker of SDB, and left atrial (LA)/LA appendage (LAA) function among AF patients. Methods We evaluated 134 consecutive AF candidates for catheter ablation (age, 59.6 ± 9.4 years; body mass index [BMI], 24.8 ± 3.2; C ongestive Heart Failure, H ypertension, A ge (≥75 years), D iabetes, S troke/Transient Ischemic Attack, V ascular Disease, A ge (65-74 years), S ex (Female) (CHA2 DS2 -VASc) score, 1.2 ± 1.1, paroxysmal AF, n = 83) using nocturnal pulse oximetry, a noninvasive screening method for nocturnal intermittent hypoxia. Based on 3% oxygen desaturation index (3% ODI), patients were divided into nocturnal intermittent hypoxia (3% ODI > 15; n = 32) and control groups (3% ODI ≤ 15; n = 102). Results The nocturnal intermittent hypoxia group demonstrated significantly higher weight, BMI, C ongestive Heart Failure, H ypertension, A ge, D iabetes, S troke/Transient Ischemic Attack (CHADS2 ) and CHA2 DS2 -VASc scores, serum hemoglobin A1c and plasma brain natriuretic peptide levels, LA size, and prevalence of hypertension, vascular disease, and sick sinus syndrome. Echocardiographically, nocturnal intermittent hypoxia was associated with a higher grade of spontaneous echo contrast and low LAA flow velocity. Multiple regression analysis adjusted for type of AF, CHA2 DS2 -VASc score, BMI, plasma brain natriuretic peptide level, LA size, and rhythm on echocardiography revealed that 3% ODI was a factor independently associated with LAA flow velocity (β = −0.184; 95% confidence interval, −0.818 to −0.006). Conclusions Nocturnal intermittent hypoxia was an independent determinant for low LAA flow velocity in patients with AF, suggesting that the connection between SDB and LAA function might underlie the association of AF with stroke. |
| doi_str_mv | 10.1016/j.cjca.2014.12.032 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1691597622</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0828282X15000227</els_id><sourcerecordid>1691597622</sourcerecordid><originalsourceid>FETCH-LOGICAL-c547t-d20cd67aa7afc06430f5e18cc9c92001173f05a0b754296462591023d098da513</originalsourceid><addsrcrecordid>eNp9kU2P0zAURS0EYsrAH2CBvGST8OzEcSIhpGo0ZUaqYMGH2Fmu84wcUrvYLtB_j0NnWLBg5c25V37nEvKcQc2Ada-m2kxG1xxYWzNeQ8MfkBUbWFdJkOIhWUHP-4r3_MsFeZLSBNAyKbvH5IKLQTRcNCtir61Fk2mw9F0w-Ri9numtzxj3Lmf0md6cDuGX0zR4ukWb6TpHV5j14YB-1F-Rbubwk37GORiXT9T5e2LjdtHNs84u-KfkkdVzwmd37yX5tLn-eHVTbd-_vb1abysjWpmrkYMZO6m11NZA1zZgBbLemMEMHIAx2VgQGnZStHzo2q4cwoA3Iwz9qAVrLsnLc-8hhu9HTFntXTJYfuExHJNi3cDEIDvOC8rPqIkhpYhWHaLb63hSDNTiV01q8asWv4pxVfyW0Iu7_uNuj-PfyL3QArw-A1iu_OEwqmQceoOji8WzGoP7f_-bf-Jmdt4ZPX_DE6Yp_Bmo3KFSCagPy8LLwEwAAOey-Q0VfKAS</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1691597622</pqid></control><display><type>article</type><title>Effect of Nocturnal Intermittent Hypoxia on Left Atrial Appendage Flow Velocity in Atrial Fibrillation</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Kimura, Takehiro, MD, PhD ; Kohno, Takashi, MD, PhD ; Nakajima, Kazuaki, MD ; Kashimura, Shin, MD ; Katsumata, Yoshinori, MD, PhD ; Nishiyama, Takahiko, MD, PhD ; Nishiyama, Nobuhiro, MD, PhD ; Tanimoto, Yoko, MD, PhD ; Aizawa, Yoshiyasu, MD, PhD ; Fukuda, Keiichi, MD, PhD ; Takatsuki, Seiji, MD, PhD</creator><creatorcontrib>Kimura, Takehiro, MD, PhD ; Kohno, Takashi, MD, PhD ; Nakajima, Kazuaki, MD ; Kashimura, Shin, MD ; Katsumata, Yoshinori, MD, PhD ; Nishiyama, Takahiko, MD, PhD ; Nishiyama, Nobuhiro, MD, PhD ; Tanimoto, Yoko, MD, PhD ; Aizawa, Yoshiyasu, MD, PhD ; Fukuda, Keiichi, MD, PhD ; Takatsuki, Seiji, MD, PhD</creatorcontrib><description>Abstract Background The mechanism underlying the associations of sleep-disordered breathing (SDB) with stroke and atrial fibrillation (AF) is not well established. We explored the relationship between nocturnal intermittent hypoxia, a marker of SDB, and left atrial (LA)/LA appendage (LAA) function among AF patients. Methods We evaluated 134 consecutive AF candidates for catheter ablation (age, 59.6 ± 9.4 years; body mass index [BMI], 24.8 ± 3.2; C ongestive Heart Failure, H ypertension, A ge (≥75 years), D iabetes, S troke/Transient Ischemic Attack, V ascular Disease, A ge (65-74 years), S ex (Female) (CHA2 DS2 -VASc) score, 1.2 ± 1.1, paroxysmal AF, n = 83) using nocturnal pulse oximetry, a noninvasive screening method for nocturnal intermittent hypoxia. Based on 3% oxygen desaturation index (3% ODI), patients were divided into nocturnal intermittent hypoxia (3% ODI > 15; n = 32) and control groups (3% ODI ≤ 15; n = 102). Results The nocturnal intermittent hypoxia group demonstrated significantly higher weight, BMI, C ongestive Heart Failure, H ypertension, A ge, D iabetes, S troke/Transient Ischemic Attack (CHADS2 ) and CHA2 DS2 -VASc scores, serum hemoglobin A1c and plasma brain natriuretic peptide levels, LA size, and prevalence of hypertension, vascular disease, and sick sinus syndrome. Echocardiographically, nocturnal intermittent hypoxia was associated with a higher grade of spontaneous echo contrast and low LAA flow velocity. Multiple regression analysis adjusted for type of AF, CHA2 DS2 -VASc score, BMI, plasma brain natriuretic peptide level, LA size, and rhythm on echocardiography revealed that 3% ODI was a factor independently associated with LAA flow velocity (β = −0.184; 95% confidence interval, −0.818 to −0.006). Conclusions Nocturnal intermittent hypoxia was an independent determinant for low LAA flow velocity in patients with AF, suggesting that the connection between SDB and LAA function might underlie the association of AF with stroke.</description><identifier>ISSN: 0828-282X</identifier><identifier>EISSN: 1916-7075</identifier><identifier>DOI: 10.1016/j.cjca.2014.12.032</identifier><identifier>PMID: 25953253</identifier><language>eng</language><publisher>England: Elsevier Inc</publisher><subject>Aged ; Atrial Appendage - diagnostic imaging ; Atrial Appendage - physiopathology ; Atrial Fibrillation - complications ; Atrial Fibrillation - diagnostic imaging ; Atrial Fibrillation - physiopathology ; Atrial Function, Left - physiology ; Cardiovascular ; Female ; Follow-Up Studies ; Humans ; Hypoxia - epidemiology ; Hypoxia - etiology ; Hypoxia - physiopathology ; Incidence ; Japan - epidemiology ; Male ; Middle Aged ; Oxygen Consumption ; Regional Blood Flow - physiology ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Sleep Apnea Syndromes - complications ; Sleep Apnea Syndromes - physiopathology ; Ultrasonography</subject><ispartof>Canadian journal of cardiology, 2015-07, Vol.31 (7), p.846-852</ispartof><rights>Canadian Cardiovascular Society</rights><rights>2015 Canadian Cardiovascular Society</rights><rights>Copyright © 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c547t-d20cd67aa7afc06430f5e18cc9c92001173f05a0b754296462591023d098da513</citedby><cites>FETCH-LOGICAL-c547t-d20cd67aa7afc06430f5e18cc9c92001173f05a0b754296462591023d098da513</cites><orcidid>0000-0003-3532-856X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0828282X15000227$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25953253$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kimura, Takehiro, MD, PhD</creatorcontrib><creatorcontrib>Kohno, Takashi, MD, PhD</creatorcontrib><creatorcontrib>Nakajima, Kazuaki, MD</creatorcontrib><creatorcontrib>Kashimura, Shin, MD</creatorcontrib><creatorcontrib>Katsumata, Yoshinori, MD, PhD</creatorcontrib><creatorcontrib>Nishiyama, Takahiko, MD, PhD</creatorcontrib><creatorcontrib>Nishiyama, Nobuhiro, MD, PhD</creatorcontrib><creatorcontrib>Tanimoto, Yoko, MD, PhD</creatorcontrib><creatorcontrib>Aizawa, Yoshiyasu, MD, PhD</creatorcontrib><creatorcontrib>Fukuda, Keiichi, MD, PhD</creatorcontrib><creatorcontrib>Takatsuki, Seiji, MD, PhD</creatorcontrib><title>Effect of Nocturnal Intermittent Hypoxia on Left Atrial Appendage Flow Velocity in Atrial Fibrillation</title><title>Canadian journal of cardiology</title><addtitle>Can J Cardiol</addtitle><description>Abstract Background The mechanism underlying the associations of sleep-disordered breathing (SDB) with stroke and atrial fibrillation (AF) is not well established. We explored the relationship between nocturnal intermittent hypoxia, a marker of SDB, and left atrial (LA)/LA appendage (LAA) function among AF patients. Methods We evaluated 134 consecutive AF candidates for catheter ablation (age, 59.6 ± 9.4 years; body mass index [BMI], 24.8 ± 3.2; C ongestive Heart Failure, H ypertension, A ge (≥75 years), D iabetes, S troke/Transient Ischemic Attack, V ascular Disease, A ge (65-74 years), S ex (Female) (CHA2 DS2 -VASc) score, 1.2 ± 1.1, paroxysmal AF, n = 83) using nocturnal pulse oximetry, a noninvasive screening method for nocturnal intermittent hypoxia. Based on 3% oxygen desaturation index (3% ODI), patients were divided into nocturnal intermittent hypoxia (3% ODI > 15; n = 32) and control groups (3% ODI ≤ 15; n = 102). Results The nocturnal intermittent hypoxia group demonstrated significantly higher weight, BMI, C ongestive Heart Failure, H ypertension, A ge, D iabetes, S troke/Transient Ischemic Attack (CHADS2 ) and CHA2 DS2 -VASc scores, serum hemoglobin A1c and plasma brain natriuretic peptide levels, LA size, and prevalence of hypertension, vascular disease, and sick sinus syndrome. Echocardiographically, nocturnal intermittent hypoxia was associated with a higher grade of spontaneous echo contrast and low LAA flow velocity. Multiple regression analysis adjusted for type of AF, CHA2 DS2 -VASc score, BMI, plasma brain natriuretic peptide level, LA size, and rhythm on echocardiography revealed that 3% ODI was a factor independently associated with LAA flow velocity (β = −0.184; 95% confidence interval, −0.818 to −0.006). Conclusions Nocturnal intermittent hypoxia was an independent determinant for low LAA flow velocity in patients with AF, suggesting that the connection between SDB and LAA function might underlie the association of AF with stroke.</description><subject>Aged</subject><subject>Atrial Appendage - diagnostic imaging</subject><subject>Atrial Appendage - physiopathology</subject><subject>Atrial Fibrillation - complications</subject><subject>Atrial Fibrillation - diagnostic imaging</subject><subject>Atrial Fibrillation - physiopathology</subject><subject>Atrial Function, Left - physiology</subject><subject>Cardiovascular</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Hypoxia - epidemiology</subject><subject>Hypoxia - etiology</subject><subject>Hypoxia - physiopathology</subject><subject>Incidence</subject><subject>Japan - epidemiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Oxygen Consumption</subject><subject>Regional Blood Flow - physiology</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Sleep Apnea Syndromes - complications</subject><subject>Sleep Apnea Syndromes - physiopathology</subject><subject>Ultrasonography</subject><issn>0828-282X</issn><issn>1916-7075</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU2P0zAURS0EYsrAH2CBvGST8OzEcSIhpGo0ZUaqYMGH2Fmu84wcUrvYLtB_j0NnWLBg5c25V37nEvKcQc2Ada-m2kxG1xxYWzNeQ8MfkBUbWFdJkOIhWUHP-4r3_MsFeZLSBNAyKbvH5IKLQTRcNCtir61Fk2mw9F0w-Ri9numtzxj3Lmf0md6cDuGX0zR4ukWb6TpHV5j14YB-1F-Rbubwk37GORiXT9T5e2LjdtHNs84u-KfkkdVzwmd37yX5tLn-eHVTbd-_vb1abysjWpmrkYMZO6m11NZA1zZgBbLemMEMHIAx2VgQGnZStHzo2q4cwoA3Iwz9qAVrLsnLc-8hhu9HTFntXTJYfuExHJNi3cDEIDvOC8rPqIkhpYhWHaLb63hSDNTiV01q8asWv4pxVfyW0Iu7_uNuj-PfyL3QArw-A1iu_OEwqmQceoOji8WzGoP7f_-bf-Jmdt4ZPX_DE6Yp_Bmo3KFSCagPy8LLwEwAAOey-Q0VfKAS</recordid><startdate>20150701</startdate><enddate>20150701</enddate><creator>Kimura, Takehiro, MD, PhD</creator><creator>Kohno, Takashi, MD, PhD</creator><creator>Nakajima, Kazuaki, MD</creator><creator>Kashimura, Shin, MD</creator><creator>Katsumata, Yoshinori, MD, PhD</creator><creator>Nishiyama, Takahiko, MD, PhD</creator><creator>Nishiyama, Nobuhiro, MD, PhD</creator><creator>Tanimoto, Yoko, MD, PhD</creator><creator>Aizawa, Yoshiyasu, MD, PhD</creator><creator>Fukuda, Keiichi, MD, PhD</creator><creator>Takatsuki, Seiji, MD, PhD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3532-856X</orcidid></search><sort><creationdate>20150701</creationdate><title>Effect of Nocturnal Intermittent Hypoxia on Left Atrial Appendage Flow Velocity in Atrial Fibrillation</title><author>Kimura, Takehiro, MD, PhD ; Kohno, Takashi, MD, PhD ; Nakajima, Kazuaki, MD ; Kashimura, Shin, MD ; Katsumata, Yoshinori, MD, PhD ; Nishiyama, Takahiko, MD, PhD ; Nishiyama, Nobuhiro, MD, PhD ; Tanimoto, Yoko, MD, PhD ; Aizawa, Yoshiyasu, MD, PhD ; Fukuda, Keiichi, MD, PhD ; Takatsuki, Seiji, MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c547t-d20cd67aa7afc06430f5e18cc9c92001173f05a0b754296462591023d098da513</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Atrial Appendage - diagnostic imaging</topic><topic>Atrial Appendage - physiopathology</topic><topic>Atrial Fibrillation - complications</topic><topic>Atrial Fibrillation - diagnostic imaging</topic><topic>Atrial Fibrillation - physiopathology</topic><topic>Atrial Function, Left - physiology</topic><topic>Cardiovascular</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Hypoxia - epidemiology</topic><topic>Hypoxia - etiology</topic><topic>Hypoxia - physiopathology</topic><topic>Incidence</topic><topic>Japan - epidemiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Oxygen Consumption</topic><topic>Regional Blood Flow - physiology</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Sleep Apnea Syndromes - complications</topic><topic>Sleep Apnea Syndromes - physiopathology</topic><topic>Ultrasonography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kimura, Takehiro, MD, PhD</creatorcontrib><creatorcontrib>Kohno, Takashi, MD, PhD</creatorcontrib><creatorcontrib>Nakajima, Kazuaki, MD</creatorcontrib><creatorcontrib>Kashimura, Shin, MD</creatorcontrib><creatorcontrib>Katsumata, Yoshinori, MD, PhD</creatorcontrib><creatorcontrib>Nishiyama, Takahiko, MD, PhD</creatorcontrib><creatorcontrib>Nishiyama, Nobuhiro, MD, PhD</creatorcontrib><creatorcontrib>Tanimoto, Yoko, MD, PhD</creatorcontrib><creatorcontrib>Aizawa, Yoshiyasu, MD, PhD</creatorcontrib><creatorcontrib>Fukuda, Keiichi, MD, PhD</creatorcontrib><creatorcontrib>Takatsuki, Seiji, MD, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Canadian journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kimura, Takehiro, MD, PhD</au><au>Kohno, Takashi, MD, PhD</au><au>Nakajima, Kazuaki, MD</au><au>Kashimura, Shin, MD</au><au>Katsumata, Yoshinori, MD, PhD</au><au>Nishiyama, Takahiko, MD, PhD</au><au>Nishiyama, Nobuhiro, MD, PhD</au><au>Tanimoto, Yoko, MD, PhD</au><au>Aizawa, Yoshiyasu, MD, PhD</au><au>Fukuda, Keiichi, MD, PhD</au><au>Takatsuki, Seiji, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of Nocturnal Intermittent Hypoxia on Left Atrial Appendage Flow Velocity in Atrial Fibrillation</atitle><jtitle>Canadian journal of cardiology</jtitle><addtitle>Can J Cardiol</addtitle><date>2015-07-01</date><risdate>2015</risdate><volume>31</volume><issue>7</issue><spage>846</spage><epage>852</epage><pages>846-852</pages><issn>0828-282X</issn><eissn>1916-7075</eissn><abstract>Abstract Background The mechanism underlying the associations of sleep-disordered breathing (SDB) with stroke and atrial fibrillation (AF) is not well established. We explored the relationship between nocturnal intermittent hypoxia, a marker of SDB, and left atrial (LA)/LA appendage (LAA) function among AF patients. Methods We evaluated 134 consecutive AF candidates for catheter ablation (age, 59.6 ± 9.4 years; body mass index [BMI], 24.8 ± 3.2; C ongestive Heart Failure, H ypertension, A ge (≥75 years), D iabetes, S troke/Transient Ischemic Attack, V ascular Disease, A ge (65-74 years), S ex (Female) (CHA2 DS2 -VASc) score, 1.2 ± 1.1, paroxysmal AF, n = 83) using nocturnal pulse oximetry, a noninvasive screening method for nocturnal intermittent hypoxia. Based on 3% oxygen desaturation index (3% ODI), patients were divided into nocturnal intermittent hypoxia (3% ODI > 15; n = 32) and control groups (3% ODI ≤ 15; n = 102). Results The nocturnal intermittent hypoxia group demonstrated significantly higher weight, BMI, C ongestive Heart Failure, H ypertension, A ge, D iabetes, S troke/Transient Ischemic Attack (CHADS2 ) and CHA2 DS2 -VASc scores, serum hemoglobin A1c and plasma brain natriuretic peptide levels, LA size, and prevalence of hypertension, vascular disease, and sick sinus syndrome. Echocardiographically, nocturnal intermittent hypoxia was associated with a higher grade of spontaneous echo contrast and low LAA flow velocity. Multiple regression analysis adjusted for type of AF, CHA2 DS2 -VASc score, BMI, plasma brain natriuretic peptide level, LA size, and rhythm on echocardiography revealed that 3% ODI was a factor independently associated with LAA flow velocity (β = −0.184; 95% confidence interval, −0.818 to −0.006). Conclusions Nocturnal intermittent hypoxia was an independent determinant for low LAA flow velocity in patients with AF, suggesting that the connection between SDB and LAA function might underlie the association of AF with stroke.</abstract><cop>England</cop><pub>Elsevier Inc</pub><pmid>25953253</pmid><doi>10.1016/j.cjca.2014.12.032</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-3532-856X</orcidid></addata></record> |
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| subjects | Aged Atrial Appendage - diagnostic imaging Atrial Appendage - physiopathology Atrial Fibrillation - complications Atrial Fibrillation - diagnostic imaging Atrial Fibrillation - physiopathology Atrial Function, Left - physiology Cardiovascular Female Follow-Up Studies Humans Hypoxia - epidemiology Hypoxia - etiology Hypoxia - physiopathology Incidence Japan - epidemiology Male Middle Aged Oxygen Consumption Regional Blood Flow - physiology Retrospective Studies Risk Assessment Risk Factors Sleep Apnea Syndromes - complications Sleep Apnea Syndromes - physiopathology Ultrasonography |
| title | Effect of Nocturnal Intermittent Hypoxia on Left Atrial Appendage Flow Velocity in Atrial Fibrillation |
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