Influence of Obstructive Apnea Index on Persistent Left Ventricular Dysfunction in Patients with ST-Segment Elevation Myocardial Infarction

In this prospective observational study, we investigated the effects of the severity and classification of sleep-disordered breathing (SDB) (obstructive, central, or mixed apnea predominant) on left ventricular (LV) dysfunction in patients with ST-segment elevation myocardial infarction (STEMI). In total, 115 patients with STEMI underwent a sleep study using a multichannel frontopolar electroencephalography recording device (Sleep Profiler ®︎ ) 1 week after STEMI onset. We evaluated LV global longitudinal strain (LV-GLS) measured using two-dimensional echocardiography (2DE) as a parameter for LV function at 1 week and 7 months. The obstructive apnea index was significantly associated with the LV-GLS at 1 week and 7 months (r = 0.27, p = 0.002; and r = 0.23, p = 0.013, respectively). However, central and mixed apnea indices were not. Multivariate linear regression analysis showed that the obstructive apnea index was independently associated with LV-GLS at 1 week and 7 months (β = 0.27, p < 0.001; and β = 0.19, p = 0.016, respectively). However, the three-type SDB classification was not significantly associated with LV-GLS. In examination of the influence of SDB on STEMI, it may be useful to focus on the obstructive apnea index rather than focusing only on the SDB classification and apnea-hypopnea index.