Obstructive sleep apnoea but not central sleep apnoea is associated with left ventricular remodelling after acute myocar
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ORIGINAL PAPER
Obstructive sleep apnoea but not central sleep apnoea is associated with left ventricular remodelling after acute myocardial infarction Christoph Fisser1 · Kristina Götz1 · Andrea Hetzenecker2 · Kurt Debl1 · Florian Zeman3 · Okka W. Hamer4 · Florian Poschenrieder4 · Claudia Fellner4 · Stefan Stadler1 · Lars S. Maier1 · Michael Pfeifer2 · Stefan Buchner1,5 · Michael Arzt1 Received: 27 January 2020 / Accepted: 2 June 2020 © The Author(s) 2020
Abstract Obejctive Obstructive sleep apnoea (OSA) increases left ventricular transmural pressure more than central sleep apnoea (CSA) owing to negative intrathoracic pressure swings. We tested the hypothesis that the severity of OSA, and not CSA, is therefore associated with spheric cardiac remodelling after acute myocardial infarction. Methods This sub-analysis of a prospective observational study included 24 patients with acute myocardial infarction who underwent primary percutaneous coronary intervention. Spheric remodelling, calculated according to the sphericity index, was assessed by cardiac magnetic resonance imaging at baseline and 12 weeks after acute myocardial infarction. OSA and CSA [apnoea-hypopnoea index (AHI) ≥ 5/hour] were diagnosed by polysomnography. Results Within 12 weeks after acute myocardial infarction, patients with OSA exhibited a significant increase in systolic sphericity index compared to patients without sleep-disordered breathing (no SDB) and patients with CSA (OSA vs. CSA vs. no SDB: 0.05 ± 0.04 vs. 0.01 ± 0.04 vs. − 0.03 ± 0.03, p = 0.002). In contrast to CSA, the severity of OSA was associated with an increase in systolic sphericity index after accounting for TIMI-flow before percutaneous coronary intervention, infarct size, pain-to-balloon-time and systolic blood pressure [OSA: B (95% CI) 0.443 (0.021; 0.816), p = 0.040; CSA: 0.193 (− 0.134; 0.300), p = 0.385]. Conclusion In contrast to CSA and no SDB, OSA is associated with spheric cardiac remodelling within the first 12 weeks after acute myocardial infarction. Data suggest that OSA-related negative intrathoracic pressure swings may contribute to this remodelling after acute myocardial infaction.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00392-020-01684-z) contains supplementary material, which is available to authorized users. * Christoph Fisser [email protected] 1
Department of Internal Medicine II, University Medical Centre Regensburg, Franz‑Josef‑Strauß‑Allee 11, 93053 Regensburg, Germany
2
Department of Pneumology, Donaustauf Hospital, Donaustauf, Germany
3
Centre for Clinical Studies, University Medical Centre Regensburg, Regensburg, Germany
4
Department of Radiology, University Medical Centre Regensburg, Regensburg, Germany
5
Department of Internal Medicine, Cham Hospital, Cham, Germany
13
Vol.:(0123456789)
Clinical Research in Cardiology
Graphic abstract
Keywords Myocardial infarction · Sleep apnoea · Sphericity · Cardiac remodelling · Wall thickness · Aneurysm · Cardiac mag
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