Chest
Clinical InvestigationsSLEEPSleep-Disordered Breathing and Myocardial Ischemia in Patients With Coronary Artery Disease
Section snippets
Patients
Men and women ≤70 years old referred for coronary angiography because of disabling angina pectoris were included in the study. Participants were randomly selected, by lot, from all eligible patients that day for an overnight sleep study. The presence of coronary disease was verified before inclusion.
The study was approved by the institutional ethics committee, and all subjects gave informed consent.
Sleep Studies
The following variables were recorded during 1 night of sleep in the hospital: oronasal airflow
Results
One hundred forty-four men and 106 women ≤ 70 years old were included. Sixteen patients (5 men, 11 women) refused to participate. After exclusions for technical failures, complete analysis of oxygen desaturation and Holter recording were obtained in 132 men and 94 women. Complete apnea analysis was obtained in 127 men and 92 women. All patients had stable angina pectoris in Canadian Cardiovascular Society class II (16%; n = 36) or III (84%; n = 190).10
One-vessel disease was found in 19%,
Discussion
Although disordered breathing is common in patients with symptomatic coronary disease,5, 6 published data about the relationship between nocturnal oxygen desaturations or apneas and myocardial ischemia are based on small and selected patient groups.7, 1112, 13 In one study of 10 men with nocturnal angina and angiographically verified coronary disease, 5 had apneas or hypopneas within 90 s before ischemia was detected using computerized vectorcardiography.7 When Holter monitoring was performed
ACKNOWLEDGMENT
We are grateful to Rolf Hörnsten for his skillful work with the ECG recordings.
References (24)
- et al.
Association of sleep apnoea with myocardial infarction in men
Lancet
(1990) - et al.
Long-term outcome for obstructive sleep apnea syndrome patients: mortality
Chest
(1988) - et al.
Sleep-disordered breathing in men with coronary artery disease
Chest
(1996) - et al.
Sleep-disordered breathing in women: occurrence and association with coronary artery disease
Am J Med
(1996) - et al.
Sleep apnoea and nocturnal angina
Lancet
(1995) - et al.
A limited diagnostic investigation for obstructive sleep apnea syndrome: oximetry and static charge sensitive bed
Chest
(1990) - et al.
Hypoxaemia and myocardial ischemia on the night before coronary bypass surgery
Br J Anaesth
(1994) - et al.
Sleep-related myocardial ischemia and sleep structure in patients with obstructive sleep apnea and coronary heart disease
Chest
(1997) - et al.
Myocardial ischemia during daily life in patients with stable angina: its relation to symptoms and heart rate changes
Lancet
(1983) - et al.
Mechanisms of nocturnal angina pectoris: importance of increased myocardial oxygen demand in patients with severe coronary artery disease
Lancet
(1984)
Global and regional left ventricular ejection fraction abnormalities during exercise in patients with silent myocardial ischemia
J Am Coll Cardiol
Impairment of myocardial perfusion and function during painless myocardial ischemia
J Am Coll Cardiol
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This study was supported by grants from the Swedish National Association for Heart and Lung Patients, the Swedish Heart Lung Foundation, the Norrland Heart Fund, and the Medical Faculty, Umeå University.