Christoph Fisser1, Alina Marcinek2, Andrea Hetzenecker2, Kurt Debl2, Andreas Luchner3, Ulrich Sterz2, Jörg Priefert2, Florian Zeman4, Malcolm Kohler5, Lars S Maier2, Stefan Buchner2, Michael Arzt2. 1. Department of Internal Medicine II, University Medical Center Regensburg, Regensburg, Germany. Electronic address: christoph.fisser@ukr.de. 2. Department of Internal Medicine II, University Medical Center Regensburg, Regensburg, Germany. 3. Clinic of Internal Medicine, Klinikum St. Marien Amberg, Amberg, Germany. 4. Center of Clinical Studies, University Medical Center Regensburg, Regensburg, Germany. 5. Clinic of Pneumology, University Hospital of Zurich, Zurich, Switzerland; Center for Interdisciplinary Sleep Research, University of Zurich, Zurich, Switzerland.
Abstract
OBJECTIVE: In patients with ST-segment elevation myocardial infarction (STEMI), disturbed cardiac repolarization before percutaneous coronary intervention (PCI) is a risk factor for malignant ventricular arrhythmia. We tested the hypothesis that sleep-disordered breathing (SDB) in patients with STEMI is associated with disturbed cardiac repolarization. METHODS: Thirty-three patients with STEMI who underwent PCI were prospectively enrolled. To assess cardiac repolarization, the heart-rate corrected interval from the peak of the T wave to the end of the T wave (TpTec) and QTc intervals were assessed with 12-lead electrocardiography before PCI, within 24 h after PCI, and 12 weeks after PCI. SDB defined as an apnea-hypopnea index (AHI) ≥15 per hour was diagnosed by polysomnography. RESULTS: Before PCI, patients with SDB had a significantly prolonged TpTec interval compared to patients without SDB (133 vs 104 ms, p = 0.035). Within 24 h after PCI, the TpTec interval was 107 vs 92 ms (p = 0.178). QTc intervals showed a similar pattern (pre-PCI: 443 vs 423 ms, p = 0.199; post-PCI: 458 vs 432 ms, p = 0.115). In multiple linear regression analyses, AHI was significantly associated with prolonged TpTec intervals (pre-PCI: B-coefficient = 1.11, 95% confidence interval (CI) 0.48-1.74, p = 0.001; post-PCI: B = 0.97, 95% CI 0.29-1.65, p = 0.007), prolonged QTc intervals (pre-PCI: B = 1.05, 95% CI 0.20-1.91, p = 0.018; post-PCI: B = 1.37, 95% CI 0.51-2.24, p = 0.003), and higher TpTe/QT-ratios (pre-PCI: B = 0.16, 95% CI 0.05-0.27, p = 0.007; post-PCI: B = 0.13, 95% CI < 0.01-0.25, p = 0.036), independent of known risk factors for cardiac arrhythmia. CONCLUSION: In patients with STEMI, SDB was significantly associated with disturbed cardiac repolarization before and after PCI, independent of known risk factors. These findings suggest that SDB may contribute to the risk of developing malignant ventricular arrhythmia.
OBJECTIVE: In patients with ST-segment elevation myocardial infarction (STEMI), disturbed cardiac repolarization before percutaneous coronary intervention (PCI) is a risk factor for malignant ventricular arrhythmia. We tested the hypothesis that sleep-disordered breathing (SDB) in patients with STEMI is associated with disturbed cardiac repolarization. METHODS: Thirty-three patients with STEMI who underwent PCI were prospectively enrolled. To assess cardiac repolarization, the heart-rate corrected interval from the peak of the T wave to the end of the T wave (TpTec) and QTc intervals were assessed with 12-lead electrocardiography before PCI, within 24 h after PCI, and 12 weeks after PCI. SDB defined as an apnea-hypopnea index (AHI) ≥15 per hour was diagnosed by polysomnography. RESULTS: Before PCI, patients with SDB had a significantly prolonged TpTec interval compared to patients without SDB (133 vs 104 ms, p = 0.035). Within 24 h after PCI, the TpTec interval was 107 vs 92 ms (p = 0.178). QTc intervals showed a similar pattern (pre-PCI: 443 vs 423 ms, p = 0.199; post-PCI: 458 vs 432 ms, p = 0.115). In multiple linear regression analyses, AHI was significantly associated with prolonged TpTec intervals (pre-PCI: B-coefficient = 1.11, 95% confidence interval (CI) 0.48-1.74, p = 0.001; post-PCI: B = 0.97, 95% CI 0.29-1.65, p = 0.007), prolonged QTc intervals (pre-PCI: B = 1.05, 95% CI 0.20-1.91, p = 0.018; post-PCI: B = 1.37, 95% CI 0.51-2.24, p = 0.003), and higher TpTe/QT-ratios (pre-PCI: B = 0.16, 95% CI 0.05-0.27, p = 0.007; post-PCI: B = 0.13, 95% CI < 0.01-0.25, p = 0.036), independent of known risk factors for cardiac arrhythmia. CONCLUSION: In patients with STEMI, SDB was significantly associated with disturbed cardiac repolarization before and after PCI, independent of known risk factors. These findings suggest that SDB may contribute to the risk of developing malignant ventricular arrhythmia.
Authors: Henrik Fox; Andrea Hetzenecker; Stefan Stadler; Olaf Oldenburg; Okka W Hamer; Florian Zeman; Leonhard Bruch; Mirko Seidel; Stefan Buchner; Michael Arzt Journal: Trials Date: 2020-01-31 Impact factor: 2.279
Authors: Michael Wester; Jan Pec; Simon Lebek; Christoph Fisser; Kurt Debl; Okka Hamer; Florian Poschenrieder; Stefan Buchner; Lars S Maier; Michael Arzt; Stefan Wagner Journal: Front Med (Lausanne) Date: 2022-02-16
Authors: Christoph Fisser; Stefan Colling; Stefan Buchner; Michael Arzt; Kurt Debl; Andrea Hetzenecker; Ulrich Sterz; Okka W Hamer; Claudia Fellner; Lars S Maier Journal: Clin Res Cardiol Date: 2021-05-12 Impact factor: 5.460
Authors: Christoph Fisser; Kristina Götz; Andrea Hetzenecker; Kurt Debl; Florian Zeman; Okka W Hamer; Florian Poschenrieder; Claudia Fellner; Stefan Stadler; Lars S Maier; Michael Pfeifer; Stefan Buchner; Michael Arzt Journal: Clin Res Cardiol Date: 2020-06-09 Impact factor: 5.460