Evaluation of Cardiac Findings Before Laboratory-Based Polysomnography [Kafkas J Med Sci]
Kafkas J Med Sci. 2023; 13(3): 231-236 | DOI: 10.5505/kjms.2023.97957  

Evaluation of Cardiac Findings Before Laboratory-Based Polysomnography

Gülay Aydın
Department of Cardiology, University of Health Sciences, Darıca Farabi Training and Research Hospital, Kocaeli, Türkiye

Aim: This study aimed to determine the demographic characteristics of the patients who applied to the Cardiology Out-patient Clinic before laboratory-based polysomnography was performed.
Material and Method: 123 adult patients undergoing laboratory-based polysomnography were included in this retrospective study. The demographic features of the patients were recorded. Routine laboratory tests, electrocardiography (ECG), transthoracic echocardiography (TTE), 24-hour ambulatory blood pressure monitoring, cardiovascular stress test, and laboratory-based polysomnography were performed in the same hospital. The apnea-hypopnea index (AHI) was used to diagnose obstructive sleep apnea syndrome (OSAS).
Results: In this study, we found the following patient findings. The mean age of the patients was 49±1.61 years. The majority of the patients were in the middle age group. Forty-two (34.10%) patients were female and 81 (65.90%) were male. Normal AHI value was detected in 5 (4.2%) patients. Mild OSAS was detected in 30 (24.2%) of the patients, moderate OSAS in 24 (18.9%), and severe OSAS in 64 (51.6%). Continuous positive airway pressure (CPAP) device report was given to 67 (54.7%) of the patients. The most accompanying comorbidity of the patients was hypertension (HT). There was a weak positive correlation between AHI and HT; r=0.280, N=95, and the relationship was statistically significant (p=0.006). Nine (7.30%) of the patients were newly diagnosed with hypertension. Invasive coronary angiography was recommended for two (1.6%) patients with positive test results, and coronary computed tomographic angiography was recommended for four (3.2%) patients. Myocardial perfusion scintigraphy was recommended to nine (7.3%) patients who could not perform cardiovascular stress tests.
Conclusion: Cardiac evaluation should be performed before laboratory-based polysomnography is performed. Electrocardiography and TTE recording should be performed on the patients, and 24-hour ABPM should be inserted. Additional tests should be performed to investigate ischemia in patients with myocardial ischemia findings.

Keywords: obstructive sleep apnea syndrome, polysomnography, cardiology


Laboratuvar Temelli Polisomnografi Öncesi Kardiyak Bulguların Değerlendirilmesi

Gülay Aydın
Sağlık Bilimleri Üniversitesi, Darıca Farabi Eğitim ve Araştırma Hastanesi, Kardiyoloji Anabilim Dalı, Kocaeli, Türkiye

Amaç: Bu çalışmanın amacı, laboratuvar temelli polisomnografi yapılmadan önce Kardiyoloji Polikliniğine başvuran hastaların demografik özelliklerini belirlemekti.
Materyal ve Metot: Bu retrospektif çalışmaya laboratuvar temelli polisomnografi yapılan 123 yetişkin hasta dâhil edildi. Hastaların demografik özellikleri kaydedildi. Rutin laboratuvar testleri, elektrokardiyografi (EKG), transtorasik ekokardiyografi (TTE), 24 saatlik ambulatuvar kan basıncı monitörizasyonu (AKBM), kardiyovasküler stres testi ve laboratuvar bazlı polisomnografi aynı hastanede yapıldı. Apne-hipopne endeksi (AHİ), obstrüktif uyku apne sendromunu (OUAS) teşhis etmek için kullanıldı.
Bulgular: Bu çalışmada hastalarda aşağıdaki bulguları bulduk. Hastaların yaş ortalaması 49±1,61 yıl idi. Hastaların 42’si (%34,1) kadın, 81’i (%65,9) erkekti. Hastaların beşinde (%4,2) normal AHİ saptandı. Hastaların 30’unda (%24,2) hafif OUAS, 24’ünde (%18,9) orta OUAS ve 64’ünde (%51,6) ağır OUAS saptandı. Hastaların 67’sine (%54,7) sürekli pozitif hava yolu basıncı (CPAP) cihazı raporu verildi. Hastalara en fazla eşlik eden komorbidite hipertansiyon idi. Apne-hipopne endeksi ile HT arasında zayıf pozitif korelasyon vardı; r=0,280, N=95, bu ilişki istatistiksel olarak anlamlıydı (p=0,006). Dokuz (%7,3) hastaya ambulatuvar kan basıncı takibi (AKBM) yapıldı ve yeni hipertansiyon tanısı konuldu. Test sonucu pozitif olan iki (%1,6) hastaya invaziv koroner anjiyografi, dört (%3,2) hastaya koroner bilgisayarlı tomografik anjiyografi önerildi. Kardiyovasküler stres testi yapamayan dokuz (%7,3) hastaya miyokardiyal perfüzyon sintigrafisi önerildi.
Sonuç: Laboratuvar tabanlı polisomnografi yapılmadan önce kardiyak değerlendirme yapılmalıdır. Hastalara EKG, TTE ve 24 saatlik AKBM yapılmalıdır. Miyokardiyal iskemi bulguları olan hastalarda iskemiyi araştırmak için ek testler yapılmalıdır.

Anahtar Kelimeler: obstrüktif uyku apne sendromu, polisomnografi, kardiyoloji


Gülay Aydın. Evaluation of Cardiac Findings Before Laboratory-Based Polysomnography. Kafkas J Med Sci. 2023; 13(3): 231-236

Corresponding Author: Gülay Aydın, Türkiye


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