不同严重程度阻塞性睡眠呼吸暂停综合征患者的心磁图特征

文献信息

中文摘要

背景： 阻塞性睡眠呼吸暂停综合征（OSAS）是心血管疾病的既定危险因素。心磁图（MCG）是一种新兴的无创电生理技术，在心血管评估中具有潜在价值；然而，其在评估OSAS严重程度方面的效用仍不明确。本研究旨在描述不同严重程度OSAS的MCG特征，并评估其对中重度疾病的预测性能。
方法： 这项回顾性研究纳入2023年6月至2024年10月期间的OSAS患者，所有患者均接受了MCG检查。患者按OSAS严重程度分层，并比较正常至轻度组与中重度组之间的MCG参数。收集基线数据、全血细胞计数、血清生化指标和MCG参数以及相关临床和实验室数据。进行单因素和多因素logistic回归分析以确定中重度OSAS的独立预测因素，并构建受试者工作特征（ROC）曲线以评估各参数及联合模型的预测性能。
结果： 组间比较显示传统OSAS严重程度危险因素（性别、体重指数等）存在显著差异。舒张功能指标，包括E/A比值和左心房大小，在组间也显示出明显差异，中重度亚组表现出更大的左心房和更高比例的E/A比值低于1。单因素分析确定了35个组间存在差异的MCG参数，而多因素回归保留了四个独立预测因素（htrt、tmdf、RS-didma和qr_rela_dist_neg_mode）。ROC分析表明，T波和QRS波相关指标具有中等预测价值；包含htrt、tmdf和RS-didma的联合模型显示出优于任何单一参数的曲线下面积。
结论： MCG参数在不同OSAS严重程度之间表现出不同特征，并对中重度OSAS具有良好的预测性能，使MCG成为一种有前景的无创早期诊断工具。观察到的舒张功能标志物变化可能提示中重度OSAS患者存在潜在的冠状动脉微循环改变。需要严格设计的前瞻性研究来验证MCG作为OSAS相关冠状动脉微循环障碍的标准化诊断方法。

英文摘要

BACKGROUND: Obstructive sleep apnea syndrome (OSAS) is an established risk factor for cardiovascular disease. Magnetocardiography (MCG) is an emerging non-invasive electrophysiological technique with potential value in cardiovascular assessment; however, its utility in evaluating OSAS severity remains unclear. This study aimed to characterize MCG features across different severities of OSAS and to evaluate their predictive performance for moderate-to-severe disease.
METHODS: This retrospective study enrolled OSAS patients between June 2023 and October 2024, all of whom underwent MCG examination. Patients were stratified by OSAS severity, and MCG parameters were compared between the normal-to-mild and moderate-to-severe groups. Baseline data, complete blood count, serum biochemical indicators, and MCG parameters were collected along with relevant clinical and laboratory data. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of moderate-to-severe OSAS, and receiver operating characteristic (ROC) curves were constructed to evaluate the predictive performance of each parameter and the combined model.
RESULTS: Group comparisons revealed significant differences in traditional OSAS severity risk factors (sex, body mass index, etc.). Diastolic function indicators, including E/A ratio and left atrial size, also showed marked differences between groups, with the moderate-to-severe subgroup exhibiting larger left atria and a higher proportion of E/A ratio values below 1. Univariate analysis identified 35 MCG parameters that differed between groups, while multivariate regression retained four independent predictors (htrt, tmdf, RS-didma, and qr_rela_dist_neg_mode). ROC analysis indicated that T-wave- and QRS-wave-related indices had moderate predictive value; a combined model incorporating htrt, tmdf, and RS-didma showed superior area under the curve compared to any single parameter.
CONCLUSION: MCG parameters demonstrate distinct characteristics across OSAS severity levels and yield favorable predictive performance for moderate-to-severe OSAS, positioning MCG as a promising non-invasive tool for early diagnosis. The observed changes in diastolic function markers may suggest underlying coronary microcirculatory alterations in patients with moderate-to-severe OSAS. Rigorously designed prospective studies are warranted to validate MCG as a standardized diagnostic modality for OSAS-related coronary microcirculation disorder.