Effect of obstructive sleep apnea syndrome on left ventricular remodeling in acute ST-elevation myocardial infarction after percutaneous coronary intervention

Abstract

Introduction. Patients with obstructive sleep apnea syndrome (OSA) may have features of acute ST-segment elevation myocardial infarction (STEMI). We assumed that the previous OSA due to acute and chronic hypoxia has a “protective” effect on myocardial damage in STEMI. To assess the damage to the myocardium, we selected the index of local contractility disorders (ILCD), and used the oxygen desaturation index (ODI) to assess OSA’s severity.Aim. To study the relationship between myocardial damage and the severity of OSA in STEMI after percutaneous coronary intervention (PCI).Material and Methods. We examined 130 patients with first-time STEMI after PCI on the infarct-associated coronary artery. Examination and treatment of patients were performed based on current procedures and standards of medical care and clinical recommendations. All patients were monitored for pulse oximetry during nighttime sleep within one week after hospitalization. The patients were divided into two groups: group A (n=59, ODI 0-5/hour, STEMI without OSA) and group B (n=71, ODI >5/ hour, STEMI with OSA).Results. Regression analysis showed that the elements of myocardium’s structural remodeling, the severity of OSA, and some biochemical indicators are included in the same indicator system and are associated with ILCD. The “left ventricular ejection fraction” (“LVEF”) indicator, estimated using the J.S. Simpson method, had the largest contribution to the ILCD in both groups of patients, while the “ID” indicator backfired on ILCD only in the group of STEMI with OAS. Thus, OSA contributed to less damage to the left ventricular myocardium in STEMI.