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Coronary heart disease and upper airway obstruction
1Department of Medicine, Cardiology and Respiratory Medicine, University of Bonn, Bonn.
Insights
Obstructive sleep apnoea syndrome (OSAS) affects over a third of coronary heart disease (CHD) patients, potentially acting as an additional risk factor. This condition requires careful consideration due to its impact on coronary haemodynamics.
Area of Science:
- Cardiology
- Sleep Medicine
- Respiratory Medicine
Background:
- Coronary heart disease (CHD) is a major cause of mortality in middle-aged men.
- Habitual snoring and obstructive sleep apnoea syndrome (OSAS) are prevalent in this demographic.
- Previous research suggests snoring is a significant risk factor for ischemic heart disease.
Purpose of the Study:
- To determine the prevalence of OSAS in patients with CHD.
- To investigate the profile of risk factors and ventricular arrhythmias in CHD patients with and without OSAS.
- To explore the relationship between OSAS and coronary artery stenosis.
Main Methods:
- Prospective study involving 78 patients with confirmed coronary artery stenosis via coronary arteriography.
- Assessment of OSAS using the respiratory disturbance index (RDI).
- Comparison of risk factors, ventricular arrhythmias, and left ventricular ejection fraction between patients with and without OSAS.
Main Results:
- OSAS was diagnosed in 34.6% of the studied CHD patients, with a mean RDI of 23.9.
- RDI showed a positive correlation with increasing age.
- No significant differences in ventricular arrhythmias or left ventricular ejection fraction were observed; however, hyperuricemia and adiposity were more common in the OSAS group.
Conclusions:
- OSAS is highly prevalent in patients with CHD and may represent an independent risk factor.
- The combination of CHD and OSAS identifies a high-risk group due to potential interactions with coronary hemodynamics.
- Sleep disturbances in patients with nocturnal myocardial ischemia warrant further investigation.
Abstract:
Coronary heart disease (CHD) is a leading cause of death among middle-aged men. In the same age group the spectrum of upper airway obstruction from habitual snoring to obstructive sleep apnoea syndrome (OSAS) is frequent. In several studies snoring was found to be an important risk factor for ischaemic heart disease. The prevalence of OSAS in patients with CHD, profile of risk factors and ventricular arrhythmias was determined in a prospective manner in 78 patients with stenosis of one or more coronary arteries at coronary arterography. OSAS was found in 27 patients (34.6%). Mean respiratory disturbance index (RDI) was 23.9. RDI increased with higher age. No significant differences in both groups could be found in ventricular arrhythmias, left ventricular ejection fraction and risk factors, except hyperuricaemia and adiposity. OSAS is frequent in patients with CHD and may be an additional risk factor besides the known coronary risk factors. Patients with the combination of CHD and OSAS have to be regarded as a group at particular risk because of several interactions between OSAS and coronary haemodynamics. Furthermore the microstructure of sleep in patients with nocturnal myocardial ischaemia is disturbed.