Sandra Van den Broecke1, Olivier Jobard2, Gilles Montalescot2, Marie Bruyneel3, Vincent Ninane3, Isabelle Arnulf4, Thomas Similowski5, Valérie Attali6. 1. AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Pneumologie et Réanimation Médicale, Paris, France; AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service des Pathologies du Sommeil, Paris, France; Service de Pneumologie, CHU St Pierre, Université Libre de Bruxelles, Brussels, Belgium. Electronic address: sandra_vandenbroecke@stpierre-bru.be. 2. AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Institut de Cardiologie, ACTION Group, Université Paris-6, Paris, France. 3. Service de Pneumologie, CHU St Pierre, Université Libre de Bruxelles, Brussels, Belgium. 4. AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service des Pathologies du Sommeil, Paris, France; Sorbonne Universités, UPMC Université Paris 06, I5, CRICM, Paris, France; INSERM, UMR_S 975; CNRS UMR 7225, Paris, France. 5. AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Pneumologie et Réanimation Médicale, Paris, France; Sorbonne Universités, UPMC Université Paris 06, UMR_S 1158, "Neurophysiologie Respiratoire Expérimentale et Clinique", F-75005, Paris, France; INSERM, UMR_S 1158, "Neurophysiologie Respiratoire Expérimentale et Clinique", Paris, France. 6. AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service des Pathologies du Sommeil, Paris, France; Sorbonne Universités, UPMC Université Paris 06, UMR_S 1158, "Neurophysiologie Respiratoire Expérimentale et Clinique", F-75005, Paris, France; INSERM, UMR_S 1158, "Neurophysiologie Respiratoire Expérimentale et Clinique", Paris, France.
Abstract
BACKGROUND: Obstructive sleep apnea (OSA) is frequently associated with acute coronary syndrome (ACS). Screening of sleep-disordered breathing (SDB) has not been previously evaluated in ACS within 72 h in intensive care settings and its management could potentially enhance patients' prognosis. This pilot study assessed the feasibility of SDB screening at the early phase of ACS. METHODS: All consecutive patients admitted to the coronary care unit (CCU) for ACS without acute heart failure underwent one overnight-attended polysomnography (PSG) within 72 h after admission. A telemonitoring (TM) system was set up to remotely monitor the signals and repair faulty sensors. The 27 recordings were analyzed as respiratory polygraphy (RP) and as PSG, and the results were compared. RESULTS: The TM system allowed successful intervention in 48% of recordings, resulting in excellent quality PSG for 89% of cases. The prevalence of SDB [apnea-hypopnea index (AHI) ≥ 15/h] was 82% and mainly consisted of central SDB and periodic breathing, except three patients with OSA. Compared with PSG, RP underestimated AHI, probably due to the poor sleep efficiency, reduction of slow-wave sleep, and alteration of rapid eye movement sleep. CONCLUSION: An early SDB screening by remote-attended PSG is feasible in ACS patients shortly after admission to CCU. The TM enhanced the quality of PSG. A high prevalence of central SDB was noticed, for which the etiology remains unknown. Further large-scale studies are needed to determine whether central SDB is an incidental finding in early ACS and whether the presence and severity of SDB have a prognostic impact.
BACKGROUND: Obstructive sleep apnea (OSA) is frequently associated with acute coronary syndrome (ACS). Screening of sleep-disordered breathing (SDB) has not been previously evaluated in ACS within 72 h in intensive care settings and its management could potentially enhance patients' prognosis. This pilot study assessed the feasibility of SDB screening at the early phase of ACS. METHODS: All consecutive patients admitted to the coronary care unit (CCU) for ACS without acute heart failure underwent one overnight-attended polysomnography (PSG) within 72 h after admission. A telemonitoring (TM) system was set up to remotely monitor the signals and repair faulty sensors. The 27 recordings were analyzed as respiratory polygraphy (RP) and as PSG, and the results were compared. RESULTS: The TM system allowed successful intervention in 48% of recordings, resulting in excellent quality PSG for 89% of cases. The prevalence of SDB [apnea-hypopnea index (AHI) ≥ 15/h] was 82% and mainly consisted of central SDB and periodic breathing, except three patients with OSA. Compared with PSG, RP underestimated AHI, probably due to the poor sleep efficiency, reduction of slow-wave sleep, and alteration of rapid eye movement sleep. CONCLUSION: An early SDB screening by remote-attended PSG is feasible in ACS patients shortly after admission to CCU. The TM enhanced the quality of PSG. A high prevalence of central SDB was noticed, for which the etiology remains unknown. Further large-scale studies are needed to determine whether central SDB is an incidental finding in early ACS and whether the presence and severity of SDB have a prognostic impact.
Authors: Adelita Tinoco; Barbara J Drew; Xiao Hu; David Mortara; Bruce A Cooper; Michele M Pelter Journal: Ann Noninvasive Electrocardiol Date: 2017-06-15 Impact factor: 1.468
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Authors: Virginie Poka-Mayap; Dodo Balkissou Adamou; Massongo Massongo; Steve Voufouo Sonwa; Jacqueline Alime; Ben Patrick Michel Moutlen; Alfred Kongnyu Njamnshi; Andre Noseda; Eric Walter Pefura-Yone Journal: PLoS One Date: 2020-01-16 Impact factor: 3.240