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Nocturnal hypoxemic burden is associated with epicardial fat volume in patients with acute myocardial infarction
Authors:Dominik Linz  Stefan Colling  Wolfgang Nußstein  Kurt Debl  Mathias Hohl  Claudia Fellner  Michael Böhm  Lars S. Maier  Okka W Hamer  Stefan Buchner  Michael Arzt
Affiliation:1.Department of Internal Medicine III, Universit?tsklinikum des Saarlandes,Homburg/Saar,Germany;2.Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, Royal Adelaide Hospital,University of Adelaide,Adelaide,Australia;3.Department of Internal Medicine II,University Medical Center Regensburg,Regensburg,Germany;4.Institute for Radiology,University Medical Center Regensburg,Regensburg,Germany;5.Innere Medizin II, Sana Klinken Cham,Cham,Germany;6.Klinik und Poliklinik für Innere Medizin II,Universit?tsklinikum Regensburg,Regensburg,Germany
Abstract:

Background

Increased epicardial fat volume (EFV) is a common feature of patients with sleep-disordered breathing (SDB), is considered as an established marker of cardiovascular risk, and is associated with adverse cardiovascular events after myocardial infarction (MI).

Methods

To investigate the association between different measures of SDB severity and EFV after acute MI, we enrolled 105 patients with acute MI in this study. Unattended in-hospital polysomnography was performed to determine the number of apneas and hypopneas per hour during sleep (apnea-hypopnea index, AHI). To determine nocturnal hypoxemic burden, we used pulse oximetry and applied a novel parameter, the hypoxia load representing the integrated area of desaturation divided by total sleep time (HLTST). Of 105 patients, 56 underwent cardiovascular magnetic resonance to define EFV.

Results

HLTST was significantly associated with EFV (r2?=?0.316, p?=?0.025). Multivariate linear regression analysis accounting for age, sex, body mass index, smoking, and left ventricular mass demonstrated that the HLTST was an independent modulator of EFV (B-coefficient 0.435 (95% CI 0.021–0.591); p?=?0.015). In contrast, AHI or established measures of hypoxemia did not correlate with EFV.

Conclusions

HLTST, a novel parameter to determine nocturnal hypoxemic burden, and not AHI as an event-based measure of SDB, was associated with EFV in patients with acute MI. Further studies are warranted to confirm the link between nocturnal hypoxemia and EFV and to determine the prognostic value of a more detailed characterization of nocturnal hypoxemic burden in patients with high cardiovascular risk.
Keywords:
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