Impact of sleep-disordered breathing on myocardial salvage and infarct size in patients with acute myocardial infarction.

نویسندگان

  • Stefan Buchner
  • Anna Satzl
  • Kurt Debl
  • Andrea Hetzenecker
  • Andreas Luchner
  • Oliver Husser
  • Okka W Hamer
  • Florian Poschenrieder
  • Claudia Fellner
  • Florian Zeman
  • Günter A J Riegger
  • Michael Pfeifer
  • Michael Arzt
چکیده

AIMS Sleep-disordered breathing (SDB) may be a risk factor for expansion of infarct size early after acute myocardial infarction (MI) by exposing the heart to repetitive oxygen desaturations and increased cardiac afterload. The objective of this study was to assess the impact of SDB on myocardial salvage and infarct size within 3 months after acute MI. METHODS AND RESULTS Patients with acute MI and percutaneous coronary intervention were enrolled in this prospective observational study. All patients underwent cardiovascular magnetic resonance (CMR) to define salvaged myocardium and infarct size within three to five days and at 3 months after acute MI. Patients were stratified according to apnoea-hypopnoea index (AHI) assessed by polysomnography at baseline into those with (AHI ≥ 15/h) and without (AHI < 15/h) SDB. Of the 56 patients included, 29 (52%) had SDB. The area at risk between both groups was similar (40 ± 12% vs. 40 ± 14%, P = 0.925). Patients with SDB had significantly less salvaged myocardium (myocardial salvage index 52% vs. 77%, P < 0.001), smaller reduction in infarct size (0.3% vs. 6.5%, P < 0.001) within 3 months after acute MI, a larger final infarct size (23% vs. 12%, P < 0.001), and a lower final left ventricular ejection fraction (48% vs. 54%, P = 0.023). In a multivariate analysis, including established risk factors for large MI, AHI was independently associated with less myocardial salvage and a larger infarct size 3 months after acute MI. CONCLUSIONS Sleep-disordered breathing was associated with less myocardial salvage and a smaller reduction in infarct size. These findings suggest a contribution of SDB to impaired healing of MI.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Role of Fructose as a Potent Antiarrhythmic and Anti-infarct agent in Isolated Rat Heart

In the current study, effects of acute short term administration of fructose on cardiac arrhythmias and myocardial infarction size following ischemia/reperfusion were investigated in isolated rat heart. The hearts were subjected to 30 min zero flow global ischemia followed by 120 min reperfusion. In the control group, the hearts were perfused by normal drug free Krebs-Henseleit (K/H) solution t...

متن کامل

Role of Fructose as a Potent Antiarrhythmic and Anti-infarct agent in Isolated Rat Heart

In the current study, effects of acute short term administration of fructose on cardiac arrhythmias and myocardial infarction size following ischemia/reperfusion were investigated in isolated rat heart. The hearts were subjected to 30 min zero flow global ischemia followed by 120 min reperfusion. In the control group, the hearts were perfused by normal drug free Krebs-Henseleit (K/H) solution t...

متن کامل

Myocardial Salvage is Reduced in Primary PCI-Treated STEMI Patients with Microvascular Obstruction, Demonstrated by Early and Late CMR

OBJECTIVES This study evaluates the association between microvascular obstruction and myocardial salvage, determined by cardiac magnetic resonance performed both in the acute stage of myocardial infarction and after 4 months. METHODS In patients with acute ST-elevation myocardial infarction treated by primary percutaneous coronary intervention, myocardial salvage, infarct size, left ventricul...

متن کامل

Effect of foot reflexology on sleep quality and severity of fatigue in patients with acute myocardial infarction: A double-blind randomized clinical trial

Introduction: Sleep disorders and fatigue are common problems in patients with acute myocardial infarction (AMI) which can lead to an increased incidence of recurrent myocardial infarction and arrhythmias. The aim of this study was to determine the effect of foot reflexology on sleep quality and fatigue severity in the AMI patients. Materials and Methods: In this double-blind randomized clinica...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • European heart journal

دوره 35 3  شماره 

صفحات  -

تاریخ انتشار 2014