Characteristics And Value Of Lorenz-RR Scattergrams In Patients With Hypertension Combined With Obstructive Sleep Apnea Hypoventilation Syndrome

Objectives To study the characteristics of Lorenz-RR scatter plot in patients with hypertension combined with obstructive sleep apnea hypopnea syndrome(OSAHS),and to analyze the correlation between Lorenz-RR scatter plot and sleep monitoring indexes,time domain and frequency domain indexes,so as to provide some reference significance for the screening of patients with hypertension combined with OSAHS.Method Patients admitted to the Department of Snoring and the Department of Cardiology of Gansu Provincial People’s Hospital from October 2021 to December 2022 were selected,and 251 patients were included according to the inclusion and exclusion criteria and divided into 3 groups according to the diseases they suffered,including 104 patients in the OSAHS group,40 patients in the hypertension group,and 107 patients in the hypertension combined with OSAHS group;The hypertension combined with OSAHS group was further divided into 2 subgroups according to the severity of apnea hypopnea index(AHI),including 33 cases in the mild to moderate group and 74 cases in the severe group;The correlation between Lorenz-RR scattergram indicators L,W,L/W,A and sleep monitoring indicators(AHI)and heart rate variability indicators was analyzed by analyzing the baseline information of each group,analyzing Lorenz-RR scattergram characteristics and heart rate variability indicators using dynamic electrocardiography.Result1.In the hypertensive group,OSAHS group,and hypertension combined with OSAHS group:(1)Comparison of baseline information between the three groups,with statistically significant differences in systolic standard deviation,24 h SBP,24 h DBP,age,BMI,and comparison(P < 0.05);(2)Statistically significant differences(P < 0.05)in the comparison of LAD,RV,IVST,IVSTs,LVEDs,and LVEDs in the comparison of cardiac echocardiograms between the three groups;(3)Comparison of heart rate variability among the three groups showed statistically significant differences in SDANN,SDNN,TP,VLF,HF,and LF comparisons(P < 0.05),and no statistically significant differences in delta index,ULF,LF/HF,RMSSD,NN50,and PNN50 comparisons(P > 0.05);(4)In the comparison of Lorenz-RR scatter plot indicators among the three groups,the difference between L comparisons was statistically significant(P < 0.05),and the difference between W,L/W,and A comparisons was not statistically significant(P > 0.05);the Lorenz-RR scatter plot graphs showed baseball beat shape,inner baseball beat shape,dilated shape,thick stick shape,thin stick shape,pike shape,and irregular shape,and the difference between the comparisons was not statistically significant(P > 0.05).2.In the two groups(mild to moderate and severe)with hyperemia combined with OSAHS,(1)Comparison of baseline data between the two groups,with statistically significant differences in heart rate,BMI,CKMB,CRP,24 h SBP,24 h DBP,and diastolic blood pressure standard deviation(P < 0.05);(2)The comparison of heart rate variability between the two groups showed statistically significant differences in delta index,ULF,LF/HF,SDNN,SDANN,RMSSD,NN50,and PNN50(P < 0.05),and no statistically significant differences in TP,VLF,LF,and HF(P > 0.05);(3)The comparison of Lorenz-RR scatter plot and sleep monitoring indexes between the two groups showed statistically significant differences in L,AHI,MSa O2,LSa O2 comparison(P < 0.05),and no statistically significant differences in W,L/W,A comparison(P > 0.05);the Lorenz-RR scatter plot graphs were baseball beat-shaped,inner baseball beat-shaped,dilated,thick stick-shaped,thin stick-shaped,The differences were not statistically significant(P > 0.05).3.In patients with hypertension combined with OSAHS,(1)In the correlation analysis of Lorenz-RR scatter plot with heart rate variability,the results showed that L was positively correlated with VLF,RMSSD,PNN50,NN50,SDNN,SDANN,delta index,HF,and LF(P < 0.05),with the highest correlation coefficients with SDANN and SDNN,both with an r of 0.791;W was positively correlated with SDNN,VLF,delta index,SDANN,RMSSD,PNN50,NN50,LF,and HF(P < 0.05),with the highest correlation coefficient with PNN50,r 0.622;L/W was positively correlated(P < 0.05)with SDNN,delta index,and SDANN,with the highest correlation coefficient with SDANN,r 0.205,and negatively correlated with RMSSD,PNN50,NN50,VLF,LF,and HF,r-0.34,-0.36,-0.39,-0.16,-0.27,and-0.327.A was positively correlated with SDNN,SDANN,RMSSD,PNN50,NN50,delta index,HF,VLF,and LF(P < 0.05),with the highest correlation coefficient with VLF,r 0.67.(2)In the correlation analysis between the Lorenz-RR scatter plot and sleep monitoring indexes,the results showed a positive correlation between L and LSa O2,MSa O2,and LVEF(P< 0.05)with correlation coefficient r values of 0.303,0.325,and 0.253,respectively;while L showed a negative correlation with AHI(P < 0.05)with a correlation coefficient of-0.257.There was no correlation between Lorenz-RR scatter plot indicators L/W,W,and A and MSa O2,LSa O2,and LVEF(P > 0.05).Conclusion(1)Significant changes in quantitative indicators of the Lorenz-RR scatter plot in patients with hypertension combined with OSAHS,with more significant decreases in L with increasing AHI;(2)Lorenz-RR scattergram patterns in patients with hypertension combined with OSAHS were baseball-beat,inner baseball-beat,dilated,thick bar,thin bar,pike,and irregular;(3)The correlation between Lorenz-RR scatter plot index L and AHI,MSa O2,LSa O2 has some correlation,which can provide some reference value for the screening of OSAHS.