Sleep-Disordered Breathing in Patients With the Brugada Syndrome
We investigated breathing patterns and the occurrence of arrhythmias and ST-segment changes during sleep in patients with Brugada syndrome. Patients with Brugada syndrome are more likely to die from ventricular arrhythmias during sleep. ST-segment changes have been correlated with risk of sudden car...
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| Veröffentlicht in: | The American journal of cardiology 2011-03, Vol.107 (5), p.709-713 |
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| creator | Macedo, Paula G., MD Brugada, Josep, MD Leinveber, Pavel, MSc Benito, Begoña, MD Molina, Irma, MD Sert-Kuniyoshi, Fatima, PhD Adachi, Taro, MD, PhD Bukartyk, Jan, MSc van der Walt, Christelle, RPSGT Konecny, Tomas, MD Maharaj, Shantal Kara, Tomas, MD, PhD Montserrat, Josep, MD Somers, Virend, MD, PhD |
| description | We investigated breathing patterns and the occurrence of arrhythmias and ST-segment changes during sleep in patients with Brugada syndrome. Patients with Brugada syndrome are more likely to die from ventricular arrhythmias during sleep. ST-segment changes have been correlated with risk of sudden cardiac death. Whether sleep disturbances may contribute to arrhythmogenesis is unknown. Patients with Brugada syndrome underwent overnight polysomnography with simultaneous 12-lead electrocardiographic recording. A control group matched by age, gender, and body mass index (BMI) also underwent polysomnography. Twenty patients were included (50 ± 15 years old, 75% men). Despite their normal BMI (24.7 ± 2.7 kg/m2 ), 45% had sleep-disordered breathing (SDB), with a mean apnea-hypopnea index of 17.2 ± 14 events/hour. In patients with a high risk of arrhythmias, 5 (63%) had SDB. In the control group, 27% had SDB. Atrial or ventricular arrhythmias were not observed. Spontaneous ST-segment changes occurred in 2 patients over 45 different time points. Most ST-segment changes were observed during rapid eye movement sleep (31%) or within 1 minute of arousals (44%). Regarding respiratory events, 25 (56%) of ST-segment changes were related to occurrence of apnea or hypopnea. In conclusion, patients with Brugada syndrome have a high prevalence of SDB even in the setting of normal BMI. The higher incidence of nocturnal death in patients with Brugada syndrome may be conceivably related to co-morbid SDB. Moreover, autonomic instability encountered in rapid eye movement sleep and arousals could potentiate the risk of arrhythmias. |
| doi_str_mv | 10.1016/j.amjcard.2010.10.046 |
| format | Article |
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Patients with Brugada syndrome are more likely to die from ventricular arrhythmias during sleep. ST-segment changes have been correlated with risk of sudden cardiac death. Whether sleep disturbances may contribute to arrhythmogenesis is unknown. Patients with Brugada syndrome underwent overnight polysomnography with simultaneous 12-lead electrocardiographic recording. A control group matched by age, gender, and body mass index (BMI) also underwent polysomnography. Twenty patients were included (50 ± 15 years old, 75% men). Despite their normal BMI (24.7 ± 2.7 kg/m2 ), 45% had sleep-disordered breathing (SDB), with a mean apnea-hypopnea index of 17.2 ± 14 events/hour. In patients with a high risk of arrhythmias, 5 (63%) had SDB. In the control group, 27% had SDB. Atrial or ventricular arrhythmias were not observed. Spontaneous ST-segment changes occurred in 2 patients over 45 different time points. Most ST-segment changes were observed during rapid eye movement sleep (31%) or within 1 minute of arousals (44%). Regarding respiratory events, 25 (56%) of ST-segment changes were related to occurrence of apnea or hypopnea. In conclusion, patients with Brugada syndrome have a high prevalence of SDB even in the setting of normal BMI. The higher incidence of nocturnal death in patients with Brugada syndrome may be conceivably related to co-morbid SDB. Moreover, autonomic instability encountered in rapid eye movement sleep and arousals could potentiate the risk of arrhythmias.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2010.10.046</identifier><identifier>PMID: 21247540</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Brugada Syndrome - complications ; Brugada Syndrome - physiopathology ; Cardiac arrhythmia ; Cardiac dysrhythmias ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Correlation analysis ; Electrocardiography ; Female ; Follow-Up Studies ; Genetic disorders ; Heart ; Humans ; Incidence ; Male ; Medical sciences ; Middle Aged ; Patients ; Pneumology ; Polysomnography - methods ; Prevalence ; Respiration ; Respiratory system : syndromes and miscellaneous diseases ; Sleep Apnea Syndromes - diagnosis ; Sleep Apnea Syndromes - etiology ; Sleep Apnea Syndromes - physiopathology ; Sleep disorders ; Sleep, REM - physiology ; Spain - epidemiology ; Young Adult</subject><ispartof>The American journal of cardiology, 2011-03, Vol.107 (5), p.709-713</ispartof><rights>Elsevier Inc.</rights><rights>2011 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Sequoia S.A. Mar 1, 2011</rights><rights>2010 Excerpta Medica, Inc. All rights reserved. 2010</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c578t-e7adace1e17dec9aad4edcdab1fe0dee9434d07787e201a669badc0c48a1b44e3</citedby><cites>FETCH-LOGICAL-c578t-e7adace1e17dec9aad4edcdab1fe0dee9434d07787e201a669badc0c48a1b44e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002914910022411$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23960443$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21247540$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Macedo, Paula G., MD</creatorcontrib><creatorcontrib>Brugada, Josep, MD</creatorcontrib><creatorcontrib>Leinveber, Pavel, MSc</creatorcontrib><creatorcontrib>Benito, Begoña, MD</creatorcontrib><creatorcontrib>Molina, Irma, MD</creatorcontrib><creatorcontrib>Sert-Kuniyoshi, Fatima, PhD</creatorcontrib><creatorcontrib>Adachi, Taro, MD, PhD</creatorcontrib><creatorcontrib>Bukartyk, Jan, MSc</creatorcontrib><creatorcontrib>van der Walt, Christelle, RPSGT</creatorcontrib><creatorcontrib>Konecny, Tomas, MD</creatorcontrib><creatorcontrib>Maharaj, Shantal</creatorcontrib><creatorcontrib>Kara, Tomas, MD, PhD</creatorcontrib><creatorcontrib>Montserrat, Josep, MD</creatorcontrib><creatorcontrib>Somers, Virend, MD, PhD</creatorcontrib><title>Sleep-Disordered Breathing in Patients With the Brugada Syndrome</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>We investigated breathing patterns and the occurrence of arrhythmias and ST-segment changes during sleep in patients with Brugada syndrome. Patients with Brugada syndrome are more likely to die from ventricular arrhythmias during sleep. ST-segment changes have been correlated with risk of sudden cardiac death. Whether sleep disturbances may contribute to arrhythmogenesis is unknown. Patients with Brugada syndrome underwent overnight polysomnography with simultaneous 12-lead electrocardiographic recording. A control group matched by age, gender, and body mass index (BMI) also underwent polysomnography. Twenty patients were included (50 ± 15 years old, 75% men). Despite their normal BMI (24.7 ± 2.7 kg/m2 ), 45% had sleep-disordered breathing (SDB), with a mean apnea-hypopnea index of 17.2 ± 14 events/hour. In patients with a high risk of arrhythmias, 5 (63%) had SDB. In the control group, 27% had SDB. Atrial or ventricular arrhythmias were not observed. Spontaneous ST-segment changes occurred in 2 patients over 45 different time points. Most ST-segment changes were observed during rapid eye movement sleep (31%) or within 1 minute of arousals (44%). Regarding respiratory events, 25 (56%) of ST-segment changes were related to occurrence of apnea or hypopnea. In conclusion, patients with Brugada syndrome have a high prevalence of SDB even in the setting of normal BMI. The higher incidence of nocturnal death in patients with Brugada syndrome may be conceivably related to co-morbid SDB. Moreover, autonomic instability encountered in rapid eye movement sleep and arousals could potentiate the risk of arrhythmias.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Brugada Syndrome - complications</subject><subject>Brugada Syndrome - physiopathology</subject><subject>Cardiac arrhythmia</subject><subject>Cardiac dysrhythmias</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Correlation analysis</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Genetic disorders</subject><subject>Heart</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Pneumology</subject><subject>Polysomnography - methods</subject><subject>Prevalence</subject><subject>Respiration</subject><subject>Respiratory system : syndromes and miscellaneous diseases</subject><subject>Sleep Apnea Syndromes - diagnosis</subject><subject>Sleep Apnea Syndromes - etiology</subject><subject>Sleep Apnea Syndromes - physiopathology</subject><subject>Sleep disorders</subject><subject>Sleep, REM - physiology</subject><subject>Spain - epidemiology</subject><subject>Young Adult</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkt9v0zAQxy3ExMrgTwBFSIinFF_ixPHLBoxtIE0CqSAerat9bR3yo9jJpP73OLQU2AtPJ_s-3_Odv8fYM-Bz4FC-rufY1ga9nWf8192ci_IBm0ElVQoK8odsxjnPUgVCnbLHIdTxCFCUj9hpBpmQheAz9mbREG3T9y703pInm7zzhMPGdevEdclnHBx1Q0i-uWGTDBuK6XGNFpPFrrO-b-kJO1lhE-jpIZ6xr9dXXy4_pLefbj5evr1NTSGrISUZRYaAQFoyCtEKssbiElbELZESubBcykpSnAfLUi3RGm5EhbAUgvIzdr6vux2XbZTGrjw2eutdi36ne3T630znNnrd3-lcVKCUigVeHQr4_sdIYdCtC4aaBjvqx6CrAqSoyiKL5It7ZN2PvovTRUjmIi9UHqFiDxnfh-BpdWwFuJ4c0rU-OKQnh6br6FDUPf97jqPqtyUReHkAMBhsVh4748IfLlclF2Jq4GLPUfz1O0deBxO9MmSdJzNo27v_tnJ-r4JpXOfio99pR-E4NOiQaa4X0zpN2wQxZgIg_wnWKMek</recordid><startdate>20110301</startdate><enddate>20110301</enddate><creator>Macedo, Paula G., MD</creator><creator>Brugada, Josep, MD</creator><creator>Leinveber, Pavel, MSc</creator><creator>Benito, Begoña, MD</creator><creator>Molina, Irma, MD</creator><creator>Sert-Kuniyoshi, Fatima, PhD</creator><creator>Adachi, Taro, MD, PhD</creator><creator>Bukartyk, Jan, MSc</creator><creator>van der Walt, Christelle, RPSGT</creator><creator>Konecny, Tomas, MD</creator><creator>Maharaj, Shantal</creator><creator>Kara, Tomas, MD, PhD</creator><creator>Montserrat, Josep, MD</creator><creator>Somers, Virend, MD, PhD</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><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>7TS</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20110301</creationdate><title>Sleep-Disordered Breathing in Patients With the Brugada Syndrome</title><author>Macedo, Paula G., MD ; Brugada, Josep, MD ; Leinveber, Pavel, MSc ; Benito, Begoña, MD ; Molina, Irma, MD ; Sert-Kuniyoshi, Fatima, PhD ; Adachi, Taro, MD, PhD ; Bukartyk, Jan, MSc ; van der Walt, Christelle, RPSGT ; Konecny, Tomas, MD ; Maharaj, Shantal ; Kara, Tomas, MD, PhD ; Montserrat, Josep, MD ; Somers, Virend, MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c578t-e7adace1e17dec9aad4edcdab1fe0dee9434d07787e201a669badc0c48a1b44e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Brugada Syndrome - complications</topic><topic>Brugada Syndrome - physiopathology</topic><topic>Cardiac arrhythmia</topic><topic>Cardiac dysrhythmias</topic><topic>Cardiology</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Correlation analysis</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Genetic disorders</topic><topic>Heart</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Pneumology</topic><topic>Polysomnography - methods</topic><topic>Prevalence</topic><topic>Respiration</topic><topic>Respiratory system : syndromes and miscellaneous diseases</topic><topic>Sleep Apnea Syndromes - diagnosis</topic><topic>Sleep Apnea Syndromes - etiology</topic><topic>Sleep Apnea Syndromes - physiopathology</topic><topic>Sleep disorders</topic><topic>Sleep, REM - physiology</topic><topic>Spain - epidemiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Macedo, Paula G., MD</creatorcontrib><creatorcontrib>Brugada, Josep, MD</creatorcontrib><creatorcontrib>Leinveber, Pavel, MSc</creatorcontrib><creatorcontrib>Benito, Begoña, MD</creatorcontrib><creatorcontrib>Molina, Irma, MD</creatorcontrib><creatorcontrib>Sert-Kuniyoshi, Fatima, PhD</creatorcontrib><creatorcontrib>Adachi, Taro, MD, PhD</creatorcontrib><creatorcontrib>Bukartyk, Jan, MSc</creatorcontrib><creatorcontrib>van der Walt, Christelle, RPSGT</creatorcontrib><creatorcontrib>Konecny, Tomas, MD</creatorcontrib><creatorcontrib>Maharaj, Shantal</creatorcontrib><creatorcontrib>Kara, Tomas, MD, PhD</creatorcontrib><creatorcontrib>Montserrat, Josep, MD</creatorcontrib><creatorcontrib>Somers, Virend, MD, PhD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Macedo, Paula G., MD</au><au>Brugada, Josep, MD</au><au>Leinveber, Pavel, MSc</au><au>Benito, Begoña, MD</au><au>Molina, Irma, MD</au><au>Sert-Kuniyoshi, Fatima, PhD</au><au>Adachi, Taro, MD, PhD</au><au>Bukartyk, Jan, MSc</au><au>van der Walt, Christelle, RPSGT</au><au>Konecny, Tomas, MD</au><au>Maharaj, Shantal</au><au>Kara, Tomas, MD, PhD</au><au>Montserrat, Josep, MD</au><au>Somers, Virend, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sleep-Disordered Breathing in Patients With the Brugada Syndrome</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2011-03-01</date><risdate>2011</risdate><volume>107</volume><issue>5</issue><spage>709</spage><epage>713</epage><pages>709-713</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>We investigated breathing patterns and the occurrence of arrhythmias and ST-segment changes during sleep in patients with Brugada syndrome. Patients with Brugada syndrome are more likely to die from ventricular arrhythmias during sleep. ST-segment changes have been correlated with risk of sudden cardiac death. Whether sleep disturbances may contribute to arrhythmogenesis is unknown. Patients with Brugada syndrome underwent overnight polysomnography with simultaneous 12-lead electrocardiographic recording. A control group matched by age, gender, and body mass index (BMI) also underwent polysomnography. Twenty patients were included (50 ± 15 years old, 75% men). Despite their normal BMI (24.7 ± 2.7 kg/m2 ), 45% had sleep-disordered breathing (SDB), with a mean apnea-hypopnea index of 17.2 ± 14 events/hour. In patients with a high risk of arrhythmias, 5 (63%) had SDB. In the control group, 27% had SDB. Atrial or ventricular arrhythmias were not observed. Spontaneous ST-segment changes occurred in 2 patients over 45 different time points. Most ST-segment changes were observed during rapid eye movement sleep (31%) or within 1 minute of arousals (44%). Regarding respiratory events, 25 (56%) of ST-segment changes were related to occurrence of apnea or hypopnea. In conclusion, patients with Brugada syndrome have a high prevalence of SDB even in the setting of normal BMI. The higher incidence of nocturnal death in patients with Brugada syndrome may be conceivably related to co-morbid SDB. Moreover, autonomic instability encountered in rapid eye movement sleep and arousals could potentiate the risk of arrhythmias.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>21247540</pmid><doi>10.1016/j.amjcard.2010.10.046</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Biological and medical sciences Brugada Syndrome - complications Brugada Syndrome - physiopathology Cardiac arrhythmia Cardiac dysrhythmias Cardiology Cardiology. Vascular system Cardiovascular Correlation analysis Electrocardiography Female Follow-Up Studies Genetic disorders Heart Humans Incidence Male Medical sciences Middle Aged Patients Pneumology Polysomnography - methods Prevalence Respiration Respiratory system : syndromes and miscellaneous diseases Sleep Apnea Syndromes - diagnosis Sleep Apnea Syndromes - etiology Sleep Apnea Syndromes - physiopathology Sleep disorders Sleep, REM - physiology Spain - epidemiology Young Adult |
| title | Sleep-Disordered Breathing in Patients With the Brugada Syndrome |
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