Central Sleep Apnoea and Arrhythmogenesis After Myocardial Infarction—The CESAAR Study
The prevalence of sleep disordered breathing (SDB) after acute myocardial infarction (AMI) is high. However, little is known about predominant SDB type and the impact of SDB severity on arrhythmogenesis. We conducted a prospective single-center observational study and performed an unattended sleep s...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2019-08-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fcvm.2019.00108/full |
| _version_ | 1818010706395529216 |
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| author | Alexander Reshetnik Swetlana Puppe Hendrik Bonnemeier |
| author_facet | Alexander Reshetnik Swetlana Puppe Hendrik Bonnemeier |
| author_sort | Alexander Reshetnik |
| collection | DOAJ |
| description | The prevalence of sleep disordered breathing (SDB) after acute myocardial infarction (AMI) is high. However, little is known about predominant SDB type and the impact of SDB severity on arrhythmogenesis. We conducted a prospective single-center observational study and performed an unattended sleep study and Holter monitoring within 10 days after AMI, and an unattended sleep study 11.3 months after AMI. All patients were included from the Department of Cardiology at the University Hospital Schleswig-Holstein, Lübeck, Germany. A total of 202 subjects with AMI (73.8% with ST-elevation; 59.8 years; 73.8% male) were included. The mean BMI was 27.8 kg/m2 and the mean neck/waist circumference was 41.7/103.3 cm. The mean left ventricular ejection fraction was 56.6%. The SDB prevalence defined as apnoea-hypopnea-index (AHI) ≥ 5/h was 66.7% with 44.9% having central (CSA), and 21.8% obstructive sleep apnoea (OSA). The mean AHI was 13.8 1/h. In 10.2% nsVT was detected in the Holter monitoring. AI >23/h was independently associated with higher risk of nsVT in the subacute AMI period. SDB is highly prevalent and CSA a predominant type of SDB in the subacute phase after uncomplicated AMI treated with modern revascularization procedures and evidence-based pharmacological therapy. Severe SDB is independently associated with higher risk for nsVT in the subacute AMI period and its course should be monitored as it can potentially have a negative impact on relevant outcomes of AMI patients. Further prospective studies are needed to assess long-term follow up of SDB after AMI and its impact on mortality and morbidity. |
| first_indexed | 2024-04-14T05:58:51Z |
| format | Article |
| id | doaj.art-6fd2e26542b64704bf118a019d857358 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-14T05:58:51Z |
| publishDate | 2019-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-6fd2e26542b64704bf118a019d8573582022-12-22T02:08:51ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2019-08-01610.3389/fcvm.2019.00108471195Central Sleep Apnoea and Arrhythmogenesis After Myocardial Infarction—The CESAAR StudyAlexander Reshetnik0Swetlana Puppe1Hendrik Bonnemeier2Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Nephrology, Berlin, GermanyDepartment of Psychiatry, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, GermanyDepartment of Cardiology, Universitätsklinik Schleswig-Holstein, Kiel, GermanyThe prevalence of sleep disordered breathing (SDB) after acute myocardial infarction (AMI) is high. However, little is known about predominant SDB type and the impact of SDB severity on arrhythmogenesis. We conducted a prospective single-center observational study and performed an unattended sleep study and Holter monitoring within 10 days after AMI, and an unattended sleep study 11.3 months after AMI. All patients were included from the Department of Cardiology at the University Hospital Schleswig-Holstein, Lübeck, Germany. A total of 202 subjects with AMI (73.8% with ST-elevation; 59.8 years; 73.8% male) were included. The mean BMI was 27.8 kg/m2 and the mean neck/waist circumference was 41.7/103.3 cm. The mean left ventricular ejection fraction was 56.6%. The SDB prevalence defined as apnoea-hypopnea-index (AHI) ≥ 5/h was 66.7% with 44.9% having central (CSA), and 21.8% obstructive sleep apnoea (OSA). The mean AHI was 13.8 1/h. In 10.2% nsVT was detected in the Holter monitoring. AI >23/h was independently associated with higher risk of nsVT in the subacute AMI period. SDB is highly prevalent and CSA a predominant type of SDB in the subacute phase after uncomplicated AMI treated with modern revascularization procedures and evidence-based pharmacological therapy. Severe SDB is independently associated with higher risk for nsVT in the subacute AMI period and its course should be monitored as it can potentially have a negative impact on relevant outcomes of AMI patients. Further prospective studies are needed to assess long-term follow up of SDB after AMI and its impact on mortality and morbidity.https://www.frontiersin.org/article/10.3389/fcvm.2019.00108/fullcentral sleep apnoeasleep disorder breathingacute myocardial infarctionnon-sustained ventricular tachycardiaarrhythmogenesis |
| spellingShingle | Alexander Reshetnik Swetlana Puppe Hendrik Bonnemeier Central Sleep Apnoea and Arrhythmogenesis After Myocardial Infarction—The CESAAR Study Frontiers in Cardiovascular Medicine central sleep apnoea sleep disorder breathing acute myocardial infarction non-sustained ventricular tachycardia arrhythmogenesis |
| title | Central Sleep Apnoea and Arrhythmogenesis After Myocardial Infarction—The CESAAR Study |
| title_full | Central Sleep Apnoea and Arrhythmogenesis After Myocardial Infarction—The CESAAR Study |
| title_fullStr | Central Sleep Apnoea and Arrhythmogenesis After Myocardial Infarction—The CESAAR Study |
| title_full_unstemmed | Central Sleep Apnoea and Arrhythmogenesis After Myocardial Infarction—The CESAAR Study |
| title_short | Central Sleep Apnoea and Arrhythmogenesis After Myocardial Infarction—The CESAAR Study |
| title_sort | central sleep apnoea and arrhythmogenesis after myocardial infarction the cesaar study |
| topic | central sleep apnoea sleep disorder breathing acute myocardial infarction non-sustained ventricular tachycardia arrhythmogenesis |
| url | https://www.frontiersin.org/article/10.3389/fcvm.2019.00108/full |
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