ORCID Profile
0000-0002-5426-6811
Current Organisation
Flinders University
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Publisher: IEEE
Date: 07-2017
Publisher: IEEE
Date: 08-2016
Publisher: Elsevier BV
Date: 02-2023
DOI: 10.1016/J.CHEST.2022.09.043
Abstract: Sleep is fragmented by brief arousals, and excessive arousal burden has been linked to increased cardiovascular (CV) risk, but mechanisms are poorly understood. Do arousals trigger cardiac ventricular repolarization lability that may predispose people to long-term cardiovascular mortality? This study analyzed 407,541 arousals in the overnight polysomnograms of 2,558 older men in the Osteoporotic Fractures in Men sleep study. QT and RR intervals were measured beat-to-beat starting 15 s prior to arousal onset until 15 s past onset. Ventricular repolarization lability was quantified by using the QT variability index (QTVi). During 10.1 ± 2.5 years of follow-up, 1,000 men died of any cause, including 348 CV deaths. During arousals, QT and RR variability increased on average by 5 and 55 ms, respectively, resulting in a paradoxical transient decrease in QTVi from 0.07 ± 1.68 to -1.00 ± 1.68. Multivariable Cox proportional hazards analysis adjusted for age, BMI, cardiovascular and respiratory risk factors, sleep-disordered breathing and arousal, diabetes, and Parkinson disease indicated that excessive QTVi during arousal was independently associated with all-cause and CV mortality (all-cause hazard ratio, 1.20 [95% CI, 1.04-1.38 P = .012] CV hazard ratio, 1.29 [95% CI, 1.01 -1.65 P = .043]). Arousals affect ventricular repolarization. A disproportionate increase in QT variability during arousal is associated with an increased all-cause and CV mortality and may reflect ventricular repolarization maladaptation to the arousal stimulus. Whether arousal-related QTVi can be used for more tailored risk stratification warrants further study, including evaluating whether arousal suppression attenuates ventricular repolarization lability and reduces subsequent mortality. ClinicalTrials.gov No.: NCT00070681 URL: www. gov.
Publisher: Oxford University Press (OUP)
Date: 20-04-2021
DOI: 10.1093/EURHEARTJ/EHAB151
Abstract: To quantify the arousal burden (AB) across large cohort studies and determine its association with long-term cardiovascular (CV) and overall mortality in men and women. We measured the AB on overnight polysomnograms of 2782 men in the Osteoporotic Fractures in Men Study (MrOS) Sleep study, 424 women in the Study of Osteoporotic Fractures (SOF) and 2221 men and 2574 women in the Sleep Heart Health Study (SHHS). During 11.2 ± 2.1 years of follow-up in MrOS, 665 men died, including 236 CV deaths. During 6.4 ± 1.6 years of follow-up in SOF, 105 women died, including 47 CV deaths. During 10.7 ± 3.1 years of follow-up in SHHS, 987 participants died, including 344 CV deaths. In women, multivariable Cox proportional hazard analysis adjusted for common confounders demonstrated that AB is associated with all-cause mortality [SOF: hazard ratio (HR) 1.58 (1.01–2.42), P = 0.038 SHHS-women: HR 1.21 (1.06–1.42), P = 0.012] and CV mortality [SOF: HR 2.17 (1.04–4.50), P = 0.037 SHHS-women: HR 1.60 (1.12–2.28), P = 0.009]. In men, the association between AB and all-cause mortality [MrOS: HR 1.11 (0.94–1.32), P = 0.261 SHHS-men: HR 1.31 (1.06–1.62), P = 0.011] and CV mortality [MrOS: HR 1.35 (1.02–1.79), P = 0.034 SHHS-men: HR 1.24 (0.86–1.79), P = 0.271] was less clear. Nocturnal AB is associated with long-term CV and all-cause mortality in women and to a lesser extent in men.
Publisher: Springer International Publishing
Date: 2022
Publisher: IEEE
Date: 10-2015
Publisher: IEEE
Date: 10-2015
Publisher: Elsevier BV
Date: 08-2023
Publisher: IEEE
Date: 10-2015
Publisher: IEEE
Date: 07-2019
Publisher: Wiley
Date: 04-10-2023
DOI: 10.1002/EHF2.14556
Publisher: IEEE
Date: 08-2606
No related grants have been discovered for Sobhan Salari Shahrbabaki.