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      Novel Predictor of the AF Development in Patients with OSAS: Importance of Visceral Adipose Index Translated title: OSAS’li Hastalarda AF Gelişiminin Yeni Bir Belirleyicisi: Visseral Adipozite İndeksinin Önemi

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          Abstract

          Objective:

          Obstructive sleep apnea syndrome (OSAS) is a sleep disorder whose frequency is increasing daily due to modern lifestyle. Patients with atrial fibrillation (AF), which has the same predisposing factors, frequently visit the outpatient clinic with complaints of palpitation. Existing symptoms are often associated with the course of OSAS, and the development of AF, a disease with high morbidity and mortality, cannot be detected. In our study, we investigated the relationship between the visceral adiposity index (VAI) and AF development in these patients.

          Methods:

          We retrospectively analyzed 207 patients with OSAS who visited the cardiology outpatient clinic. The data of 44 patients with AF and 163 patients without AF were compared.

          Results:

          Demographic characteristics and clinical risk factors were similar between the groups (p>0.05). VAI, apnea-hypopnea index, and inflammatory markers were higher in the AF group, and these risk factors were significant in the multivariate analysis (p<0.05).

          Conclusions:

          Our study is important in terms of showing VAI as one of the most important predictors of AF, which has an impact on mortality and morbidity in patients with OSAS, whose frequency is increasing daily. Further prospective studies are required to confirm our observations and determine their clinical applicability.

          Translated abstract

          Amaç:

          Obstrüktif uyku apne sendromu (OSAS) modern yaşam tarzı nedeniyle sıklığı her geçen gün artan bir uyku bozukluğudur. Atrial fibrilasyon (AF) ile aynı predispozan faktörlere sahip olan hastalıkta hastalar çok sık çarpıntı şikayeti ile polikliniğe başvurmaktadır. Mevcut semptomlar sıklıkla OSAS hastalığın seyrine bağlanmakta ve morbiditesi ve mortalitesi yüksek bir hastalık olan AF’nin gelişimi yakalanamamaktadır. Çalışmamızda bu hastalardaki visseral adipozite indeksi (VAI) ile AF gelişimi arasındaki ilişkiyi araştırmayı amaçladık.

          Yöntemler:

          Çalışmamızda kardiyoloji polikliniğine başvuran 207 hastanın verileri retrospektif olarak analiz edildi. AF gelişen 44 ve gelişmeyen 163 hastanın verileri karşılaştırıldı.

          Bulgular:

          Gruplar arası demografik özellikler ve klinik risk faktörleri benzerdi (p>0,05). AF gelişen grupta VAI, apne-hipopne indeksi ve enflamatuvar markerların daha yüksek olduğu saptandı ve multivariate analizde bu risk faktörlerinin anlamlı olduğu tespit edildi (p<0,05).

          Sonuçlar:

          Çalışmamız sıklığı her geçen gün artan OSAS’li hastalarda mortalite ve morbidite üzerinde etkisi olan AF’nin en önemli prediktörlerinden birisi olarak VAI’yı göstermesi bakımından önemli olduğunu saptadık. Gözlemlerimizi doğrulamak ve klinik uygulanabilirliğini belirlemek için daha ileri prospektif çalışmalara ihtiyaç vardır.

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          Most cited references40

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          Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging.

          The rapid technological developments of the past decade and the changes in echocardiographic practice brought about by these developments have resulted in the need for updated recommendations to the previously published guidelines for cardiac chamber quantification, which was the goal of the joint writing group assembled by the American Society of Echocardiography and the European Association of Cardiovascular Imaging. This document provides updated normal values for all four cardiac chambers, including three-dimensional echocardiography and myocardial deformation, when possible, on the basis of considerably larger numbers of normal subjects, compiled from multiple databases. In addition, this document attempts to eliminate several minor discrepancies that existed between previously published guidelines.
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            Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma.

            We developed a novel systemic immune-inflammation index (SII) based on lymphocyte, neutrophil, and platelet counts and explored its prognostic value in hepatocellular carcinoma (HCC).
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              Prevalence of obstructive sleep apnea in the general population: A systematic review.

              With this systematic review we aimed to determine the prevalence of obstructive sleep apnea (OSA) in adults in the general population and how it varied between population sub-groups. Twenty-four studies out of 3807 found by systematically searching PubMed and Embase databases were included in this review. Substantial methodological heterogeneity in population prevalence studies has caused a wide variation in the reported prevalence, which, in general, is high. At ≥5 events/h apnea-hypopnea index (AHI), the overall population prevalence ranged from 9% to 38% and was higher in men. It increased with increasing age and, in some elderly groups, was as high as 90% in men and 78% in women. At ≥15 events/h AHI, the prevalence in the general adult population ranged from 6% to 17%, being as high as 49% in the advanced ages. OSA prevalence was also greater in obese men and women. This systematic review of the overall body of evidence confirms that advancing age, male sex, and higher body-mass index increase OSA prevalence. The need to a) consider OSA as having a continuum in the general population and b) generate consensus on methodology and diagnostic threshold to define OSA so that the prevalence of OSA can be validly compared across regions and countries, and within age-/sex-specific subgroups, is highlighted.
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                Author and article information

                Journal
                Medeni Med J
                Medeni Med J
                medj
                Medeniyet Medical Journal
                Galenos Publishing
                2149-2042
                2149-4606
                December 2023
                26 December 2023
                : 38
                : 4
                : 252-259
                Affiliations
                [1 ]Trakya University Faculty of Medicine, Department of Cardiology, Edirne, Turkey
                Author notes
                * Address for Correspondence: Trakya University Faculty of Medicine, Department of Cardiology, Edirne, Turkey E-mail: drugurozkan@ 123456hotmail.com
                Author information
                https://orcid.org/0000-0002-7552-7654
                https://orcid.org/0000-0001-5650-9066
                Article
                64151
                10.4274/MMJ.galenos.2023.07455
                10759944
                38148713
                e9be5400-ead2-4297-91e2-efbbce1cb691
                Copyright© 2023 The Author. Published by Galenos Publishing House on behalf of Istanbul Medeniyet University Faculty of Medicine.

                This is an open access article under the Creative Commons AttributionNonCommercial 4.0 International (CC BY-NC 4.0) License.

                History
                : 2 August 2023
                : 2 November 2023
                Categories
                Original Article

                apnea-hypopnea index,obstructive sleep apnea syndrome,visceral adiposity index,apne-hipopne indeksi,obstrüktif uyku apne sendromu,visseral adipozite indeksi

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