OBSTRUCTIVE SLEEP APNOEA SYNDROME AND CLINICAL STATUS OF PATIENTS WITH ACUTE MYOCARDIAL INFARCTION AND PREEXISTING STABLE ANGINA
Abstract
Aim. To investigate the effects of obstructive sleep apnoea (OSA) on clinical and functional status of patients with acute myocardial infarction (AMI); to assess the association between pre-existing stable angina and AMI clinical course in the first 3 months. Material and methods. The study included 68 AMI patients; in 38 participants, OSA was diagnosed based on the electrocardiography and breathing monitoring results. All patients underwent echocardiography and veloergometry. Results. In OSA patients, AMI risk was higher among young individuals with preexisting diabetes mellitus and arterial hypertension. OSA severity was maximal during the acute phase of AMI. Clinical course of AMI in OSA patients was characterised by disturbed cardiac hemodynamics and progressing myocardial ischemia; during the follow-up period, significant improvement was observed only for the latter. Preexisting stable angina partly counterbalanced negative effects of OSA, being linked to a 1,9-fold reduction in the number of ischemic episodes, and a 2,2-fold decrease in total ischemia duration over 24 hours. Conclusion. The results obtained should be taken into consideration while treating AMI and preventing its complications.
About the Authors
A. P. Ivanov
Tver Medical Academy, Tver
Tver Clinical Cardiology Dispanser, Tver
Russian Federation
Russian Federation
D. V. Klyukvin
City Hospital No. 3, Zelenograd, Russia
Russian Federation
Russian Federation
V. V. Rostorotskaya
Tver Medical Academy, Tver
Tver Clinical Cardiology Dispanser, Tver
Russian Federation
Russian Federation
I. A. Elgardt
Tver Clinical Cardiology Dispanser, Tver
Russian Federation
Russian Federation
References
1. Shimsuzzaman A. S., Gersh B. J., Somers V.K. Obstructive sleep apnea: Implications for cardiac and vascular disease. JAMA 2003; 290: 1906–14.
2. Moruzzi P., Sarzi-Brada S., Rossi M. et al. Sleep apnea in ischemic heart disease: Differences between acute and chronic coronary syndrome. Heart 1999; 82: 343–7.
3. Hayashi M., Fujimoto K., Urushibata K. et al. Nocturnal oxygen desaturation correlates with the severity of coronary atherosclerosis in coronary artery disease. Chest 2003; 124: 936–41.
4. Kogan-Ponomarev M. J., Samko A. N., Chodeewa G. V. Influence previous a heart attack of a myocardium a stenocardia for its size, treatment and the forecast? Clinical aspects of a phenomenon of adaptation to an ischemia. Cardiology 1998; 9; 60–4. Russian (Коган-Пономарев М.Я., Самко А. Н., Ходеева Г.В. Влияет ли предшествующая инфаркту миокарда стенокардия на его размер, лечение и прогноз? Клинические аспекты феномена адаптации к ишемии. Кардиология 1998; 9: 60–4).
5. Tanigawa T., Horie S., Sakutai S., Ito H/Screening sor sleep-disordered breathing at workplaces. Ind Health 2005; 43: 53–7.
6. Szimanski F. M., Filipiak K. J., Hrynkiewicx-Szymanska A. et al. The high risk of obstructive sleep apnea – An independent risk factor of erectile dysfunction in ST-segment elevation myocardial infarction patients. J Sex Med 2011; 8: 1434–8.
7. Shirasaki O., Kuwaba M., Saito M. et al. Development and clinical application of a new technique for detected “sleep blood pressure surged” in sleep apnea patients based on a variable desaturation threshold. Hypertens Res 2011; 34: 922–8.
8. Damy T., Paulino A., Margarit L. et al. Lrft ventricular remodeling is associated with sleepdisordered breathing in non-ischemic cardiopathy with systolic dysfunction. J Sleep Res 2011; 20: 101–9.
9. Tsukamoto K., Ohara A. Temporal worsening of sleep-disordered breathing in the acute phase of myocardial infarction. Circ J 2006; 70: 1553–6.
10. Skinner M.A., Choudhury M.S., Homan S.D. et al. Accuracy of monitoring for sleeprelated breathing disorders in the coronary care unit. Chest 2005; 127: 66–71.
11. Ivanov A.P., Gornostaeva T.S., Elgardt I.A. Role previous a heart attack of a myocardium of a stenocardia and a phenomenon ischemic preconditioning in safety of a coronary reserve in early postinfarction period. Cardiovascular Therapy and Prevention 2006; 1: 71–5. Russian (Иванов А.П., Горностаева Т.С., Эльгардт И.А. Роль предшествующей инфаркту миокарда стенокардии и феномена ишемического прекондиционирования в сохранности коронарного резерва в раннем постинфарктном периоде. Кардиоваскулярная терапия и профилактика 2006; 1: 71–5).
12. Kajstra J., Leri A., Anversa P. et al. Myocyte proliferation and ventricular remodeling. J Card Fail 2004; 8: 518–25.
Review
For citations:
Ivanov A.P., Klyukvin D.V., Rostorotskaya V.V., Elgardt I.A. OBSTRUCTIVE SLEEP APNOEA SYNDROME AND CLINICAL STATUS OF PATIENTS WITH ACUTE MYOCARDIAL INFARCTION AND PREEXISTING STABLE ANGINA. Russian Journal of Cardiology. 2012;(2):21-26. (In Russ.)
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