Source: Annual Congress 2010 - Nocturnal cardiology: chronic heart failure, acute chest syndrome, coronary artery disease and collagen vascular disease
Disease area: Pulmonary vascular diseases, Sleep and breathing disorders

Abstract

Rationale: Impaired cardiac function may promote the development of sleep apnea (SA). The aim of this study was to determine whether changes of left ventricular ejection fraction (LVEF) after acute myocardial infarction (AMI) over a period of 12 weeks correlates with severity of SA.
Methods: Twenty-one consecutive patients (81% male, age 56±2) with AMI underwent polysomnography (PSG) and cardiovascular magnetic resonance imaging (CMR) within 5 days after AMI and 12 weeks later. We stratified the sample in patients who improved their LVEF within 12 weeks after AMI by ≥5% (ΔLVEF≥5%) and in those who did not (ΔLVEF<5%).
Results: Prevalence of severe SA (respiratory disturbance index, RDI≥30/h) within 5 days and 12 weeks after AMI was 68 and 45%, respectively. The ΔLVEF≥5%-group (n=10) showed a significant increase in LVEF from 42±2% to 51±2% (p<0.001) within 12 weeks after AMI, whereas LVEF in the ΔLVEF<5%-group (n=11) remained unchanged (40±3% to 41±4%, p=0.987). RDI within 5 days after AMI in the ΔLVEF≥5% and <5%-group was similar (37±5 versus 42±9/h, p=0.640). Severity of SA was significantly more reduced over the 12 week period after AMI in the ΔLVEF≥5%-group compared to the ΔLVEF<5%-group (ΔRDI: -14±4 versus 0±5/h, p=0.05).
Conclusion: Severe SA is highly prevalent in the early phase after AMI. Improvement of cardiac function within the first 12 weeks after AMI is associated with a significant attenuation of SA. Findings indicate that the decision to treat SA in the long term should be based on sleep diagnostics, when cardiac function is stable.

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T. Greimel, S. Buchner, A. Luchner, O. W. Hamer, K. Debl, A. Brandl-Novak, A. Braune, R. Obermeier, M. Pfeifer, M. Arzt (Donaustauf, Germany). Natural course of sleep apnea after acute myocardial infarction according to the development of left ventricular function. Eur Respir J 2010; 36: Suppl. 54, 907

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