Patients with obstructive sleep apnea exhibit impaired endothelial function after myocardial infarction

Fatima H. Sert Kuniyoshi, Prachi Singh, Apoor S. Gami, Arturo Garcia-Touchard, Christelle Van Der Walt, Snigdha Pusalavidyasagar, R. Scott Wright, Elisardo Corral Vasquez, Francisco Lopez-Jimenez, Virend Somers

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Abstract

Background: Impaired brachial flow-mediated dilation (FMD) is associated with risk for subsequent cardiovascular events in patients after myocardial infarction (MI). These patients often have obstructive sleep apnea (OSA). We tested the hypothesis that patients with OSA post MI will exhibit more severe impairment in FMD. Methods: We studied 64 patients with MI admitted to our hospital. OSA was determined using polysomnography. FMD was measured using high-resolution ultrasonography, with researchers blind to the OSA diagnosis. Results: The mean age was 60 ± 11 years, and the mean BMI was 29 (26, 32 kg/m2), 84% of patients were men, 39% had moderate to severe OSA (apnea-hypopnea index [AHI]> 15), and 31% of the patients had mild OSA (5 ≤ AHI< 15). FMD was severely impaired in patients with moderate to severe OSA (0.8% ± 0.7%) as compared with patients without OSA (4.7% ± 0.8%, P =.001) and with mild OSA (3.9% ± 0.8%, P =.015). Linear regression showed that FMD was associated with log nocturnal nadir oxygen saturation (minSaO2) (β = 31.17, P =.0001), age (β = - 0.11, P =.006). MinSaO2 was an independent predictor of FMD after adjustment for possible confounders (β = 26.15, P =.001). Conclusions: FMD is severely impaired in patients with moderate to severe OSA post MI, which may be partially related to nocturnal hypoxemia. Patients with OSA may, therefore, be at higher risk for subsequent cardiovascular events after an MI. Identifying and treating OSA may have important implications in the long-term prognosis of patients post MI. Further studies are necessary to determine if the presence of OSA would affect the long-term occurrence of cardiovascular events after an MI.

Original languageEnglish (US)
Pages (from-to)62-67
Number of pages6
JournalChest
Volume140
Issue number1
DOIs
StatePublished - Jul 1 2011

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Obstructive Sleep Apnea
Myocardial Infarction
Dilatation
Apnea
Polysomnography
Linear Models
Ultrasonography
Arm
Research Personnel

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Sert Kuniyoshi, F. H., Singh, P., Gami, A. S., Garcia-Touchard, A., Van Der Walt, C., Pusalavidyasagar, S., ... Somers, V. (2011). Patients with obstructive sleep apnea exhibit impaired endothelial function after myocardial infarction. Chest, 140(1), 62-67. https://doi.org/10.1378/chest.10-1722

Patients with obstructive sleep apnea exhibit impaired endothelial function after myocardial infarction. / Sert Kuniyoshi, Fatima H.; Singh, Prachi; Gami, Apoor S.; Garcia-Touchard, Arturo; Van Der Walt, Christelle; Pusalavidyasagar, Snigdha; Wright, R. Scott; Vasquez, Elisardo Corral; Lopez-Jimenez, Francisco; Somers, Virend.

In: Chest, Vol. 140, No. 1, 01.07.2011, p. 62-67.

Research output: Contribution to journalArticle

Sert Kuniyoshi, FH, Singh, P, Gami, AS, Garcia-Touchard, A, Van Der Walt, C, Pusalavidyasagar, S, Wright, RS, Vasquez, EC, Lopez-Jimenez, F & Somers, V 2011, 'Patients with obstructive sleep apnea exhibit impaired endothelial function after myocardial infarction', Chest, vol. 140, no. 1, pp. 62-67. https://doi.org/10.1378/chest.10-1722
Sert Kuniyoshi FH, Singh P, Gami AS, Garcia-Touchard A, Van Der Walt C, Pusalavidyasagar S et al. Patients with obstructive sleep apnea exhibit impaired endothelial function after myocardial infarction. Chest. 2011 Jul 1;140(1):62-67. https://doi.org/10.1378/chest.10-1722
Sert Kuniyoshi, Fatima H. ; Singh, Prachi ; Gami, Apoor S. ; Garcia-Touchard, Arturo ; Van Der Walt, Christelle ; Pusalavidyasagar, Snigdha ; Wright, R. Scott ; Vasquez, Elisardo Corral ; Lopez-Jimenez, Francisco ; Somers, Virend. / Patients with obstructive sleep apnea exhibit impaired endothelial function after myocardial infarction. In: Chest. 2011 ; Vol. 140, No. 1. pp. 62-67.
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abstract = "Background: Impaired brachial flow-mediated dilation (FMD) is associated with risk for subsequent cardiovascular events in patients after myocardial infarction (MI). These patients often have obstructive sleep apnea (OSA). We tested the hypothesis that patients with OSA post MI will exhibit more severe impairment in FMD. Methods: We studied 64 patients with MI admitted to our hospital. OSA was determined using polysomnography. FMD was measured using high-resolution ultrasonography, with researchers blind to the OSA diagnosis. Results: The mean age was 60 ± 11 years, and the mean BMI was 29 (26, 32 kg/m2), 84{\%} of patients were men, 39{\%} had moderate to severe OSA (apnea-hypopnea index [AHI]> 15), and 31{\%} of the patients had mild OSA (5 ≤ AHI< 15). FMD was severely impaired in patients with moderate to severe OSA (0.8{\%} ± 0.7{\%}) as compared with patients without OSA (4.7{\%} ± 0.8{\%}, P =.001) and with mild OSA (3.9{\%} ± 0.8{\%}, P =.015). Linear regression showed that FMD was associated with log nocturnal nadir oxygen saturation (minSaO2) (β = 31.17, P =.0001), age (β = - 0.11, P =.006). MinSaO2 was an independent predictor of FMD after adjustment for possible confounders (β = 26.15, P =.001). Conclusions: FMD is severely impaired in patients with moderate to severe OSA post MI, which may be partially related to nocturnal hypoxemia. Patients with OSA may, therefore, be at higher risk for subsequent cardiovascular events after an MI. Identifying and treating OSA may have important implications in the long-term prognosis of patients post MI. Further studies are necessary to determine if the presence of OSA would affect the long-term occurrence of cardiovascular events after an MI.",
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AU - Van Der Walt, Christelle

AU - Pusalavidyasagar, Snigdha

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