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European Heart Journal Advance Access published online on September 6, 2006
European Heart Journal, doi:10.1093/eurheartj/ehl219
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European Heart Journal © The European Society of Cardiology 2006; all rights reserved
Received January 30, 2006
Revised August 10, 2006
Accepted August 17, 2006

Clinical research

Obstructive sleep apnoea inhibits the recovery of left ventricular function in patients with acute myocardial infarction

Hiroshi Nakashima 1 *, Toshiro Katayama 1, Chisa Takagi 1, Kentarou Amenomori 1, Masahiko Ishizaki 1, Yukiharu Honda 1, and Shin Suzuki 1

1 Department of Cardiology, Nagasaki Citizens Hospital, Schinchi-machi 6-39, Nagasaki, Japan

* To whom correspondence should be addressed.
Hiroshi Nakashima, E-mail: sk4h-nksm{at}asahi-net.or.jp


  Abstract

Aims It has been suggested that obstructive sleep apnoea syndrome (OSA) may be a direct cause of left ventricular (LV) systolic dysfunction. This study was designed to examine our hypothesis that OSA inhibits the recovery of LV function in patients with acute myocardial infarction (AMI).

Methods and results Our 86 consecutive first-AMI patients underwent primary percutaneous coronary intervention (PCI). All patients underwent polysomnography and OSA was defined as an apnoea-hypoapnoea index (AHI)  ≥ 15 events/h, of which more than 50% were obstructive. Left ventriculograms immediately after PCI and at 21 days were used to evaluate LV ejection fraction (LVEF), LV end-diastolic volume index, and regional wall motion (RWM) within the infarct area. OSA was observed in 37 patients (43%). All three indices of LV function after primary PCI were comparable between the two groups. Increases in LVEF and RWM during admission were significantly lower in OSA patients than those without OSA (delta LVEF:  - 0.3 ± 9.6 vs. 7.4 ± 7.2%, P < 0.001; delta RWM: 0.26 ± 1.04 SD/chord vs. 1.16 ± 1.20 SD/chord, P = 0.002). Multiple regression analysis showed that AHI correlated negatively with delta LVEF and delta RWM.

Conclusion The novel finding is that OSA may inhibit the recovery of LV function in patients with AMI.

Keywords: Obstructive sleep apnea; Acute myocardial infarction; Primary percutaneus coronary intervention.
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