title: Natural course of sleep-disordered breathing after acute myocardial infarction.
abstract: The aim of this study was to test whether an improvement of left ventricular ejection fraction (EF) in the early phase after acute myocardial infarction is associated with a reduction of the severity of central and obstructive sleep apnoea. 40 consecutive patients with acute myocardial infarction underwent polysomnography and cardiovascular magnetic resonance imaging within 5 days and 12 weeks after the event to assess sleep apnoea and cardiac function. We stratified the sample in patients who improved their left ventricular EF within 12 weeks by ≥ 5% (improved EF group, ΔEF 9 ± 1%, n=16) and in those who did not (unchanged EF group, ΔEF -1 ± 1%, n=24). Prevalence of sleep apnoea (≥ 15 apnoea and hypopnoea events·h(-1)) within ≤ 5 days after myocardial infarction was 55%. Apnoea and hypopnoea events·h(-1) were significantly more reduced in the improved EF group compared with the unchanged EF group (-10 ± 3 versus 1 ± 3 events·h(-1); p=0.036). This reduction was based on a significant alleviation of obstructive events (-7 ± 2 versus 4 ± 3 events·h(-1); p=0.009), while the reduction of central events was similar between groups (p=0.906). An improvement of cardiac function early after myocardial infarction is associated with an alleviation of sleep apnoea. This finding suggests that re-evaluation of treatment indication for sleep apnoea is needed when a change in cardiac function occurs.
authors.affiliation: Klinik und Poliklinik fur Innere Medizin II, Universitätsklinikum Regensburg, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Buchner
authors.forename: Tanja
authors.initials: T
authors.lastname: Greimel
authors.forename: Andrea
authors.initials: A
authors.lastname: Hetzenecker
authors.forename: Andreas
authors.initials: A
authors.lastname: Luchner
authors.forename: Okka W
authors.initials: OW
authors.lastname: Hamer
authors.forename: Kurt
authors.initials: K
authors.lastname: Debl
authors.forename: Florian
authors.initials: F
authors.lastname: Poschenrieder
authors.forename: Claudia
authors.initials: C
authors.lastname: Fellner
authors.forename: Günter A J
authors.initials: GA
authors.lastname: Riegger
authors.forename: Michael
authors.initials: M
authors.lastname: Pfeifer
authors.forename: Michael
authors.initials: M
authors.lastname: Arzt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000503:physiopathology*; D011446:Prospective Studies; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000503:physiopathology*; D055815:Young Adult