Ventricular Remodeling after Myocardial Infarct: A Minireview on the Impact of Obstructive Sleep Apnea Syndrome

Abstract

Obstructive sleep apnoea (OSA) is recognized as an important cardiovascular risk factor and is intricate with coronary disease. OSA could be involved in worsening the cardiac remodeling following the acute myocardial infarction (AMI). Cardiac remodeling is an important determinant of the clinical outcome of heart failure and is linked to disease progression and poor prognosis. The aims of this minireview are to address the frequency reported in the literature of OSA in patients with AMI and to summarize the main mechanisms of cardiac remodeling by OSA and its consequences on cardiovascular system. In addition, we aim to identify new strategies in the management of AMI. OSA is frequent in patients with AMI. OSA may have a role in cardiac remodeling after AMI and especially in relationship with the increased sensitivity of the reperfused tissue to all underlying mechanisms: a complex interplay of mechanical or haemodynamic factors, reactive oxygen species balance, sympathetic nerve activity, endothelial dysfunction, proinflammatory factors and coagulation abnormalities. Continuous positive airway pressure CPAP might represent a non pharmalogical treatment in addition to the global management of patients with AMI.