Abstract 17402: Sleep Apnea Predicts the Extent of Myocardial Damage After Acute Myocardial Infarction Determined by Cardiovascular Magnetic Resonance Imaging
Background: In patients with acute myocardial infarction (AMI) sleep apnea (SA) exposes the heart to repetitive oxygen desaturations and increased cardiac afterload. The relation between SA and the extent of myocardial infarct size has not been studied yet. The objective of this clinical evaluation was to test the hypothesis that SA is among known risk factors associated with larger infarct size in AMI patients, using cardiovascular magnetic resonance (CMR).
Methods: We studied 24 patients with AMI who were successfully treated with percutaneous coronary intervention. All patients underwent polysomnography and delayed contrast-enhanced CMR was performed to define myocardial scar. Patients were stratified into two groups according to the infarct size. A large infarct size 3 months after AMI was defined as ≥24g assessed by CMR. To determine predictors of large infarct size we used multivariate logistic regression analysis.
Results: Overall, the mean infarct size was 23±12 g. The mean AHI was significantly higher in the greater infarct size group compared to the smaller infarct size group (37±8/hour vs 16±8/hour, p=0.02). Multivariate analysis including age, gender and time-to-reperfusion revealed that AHI was an independent risk factor (p=0.034) for greater infarct size (≥24 g).
Conclusion: In addition to late or insufficient revascularisation SA predicts the development of a large myocardial scar three months after myocardial infarction.
- © 2011 by American Heart Association, Inc.