Sleep Disordered Breathing and Mortality in Patients With Hypertrophic Obstructive Cardiomyopathy Undergoing Septal Myectomy.

Published on Sep 1, 2021
· DOI :10.1016/J.MAYOCP.2021.03.036
Hao Cui4
Estimated H-index: 4
(Mayo Clinic),
Hartzell V. Schaff131
Estimated H-index: 131
(Mayo Clinic)
+ 5 AuthorsSteve R. Ommen78
Estimated H-index: 78
(Mayo Clinic)
Abstract null null Objective null To determine the impact of sleep-disordered breathing (SDB) on survival in patients with hypertrophic cardiomyopathy (HCM) following septal myectomy. null null null Patients and Methods null Patients with obstructive HCM undergoing septal myectomy from 2007 to 2016 were reviewed. Those who had an overnight oximetry test within 6 months before myectomy were included in analysis. Oxygen desaturation index was examined continuously and also categorically (SDB [>5/h] and severe SDB [>15/h]). null null null Results null A total of 619 of 1500 patients undergoing septal myectomy had overnight oximetry tests. Sleep-disordered breathing (oxygen desaturation index >5/h) was identified in 338 (54.6%) patients, and among those patients, 117 (18.9%) were classified as severe. Patients with SDB were older, had greater body mass index and body surface area, were more likely to have arterial hypertension and atrial fibrillation, and had an increased E/e’ ratio on Doppler echocardiography. Notably, there was no difference in preoperative resting left ventricular outflow tract pressure gradient between patients with SDB and those with normal overnight oximetry (55 (interquartile range: 25 to 86) mm Hg versus 52 (interquartile range: 21 to 85) mm Hg; P=.29). There was no difference in age-adjusted survival among patients with normal oximetry compared with those with mild SDB (hazard ratio: 0.98; 95% CI: 0.45 to 2.17), and severe SDB (hazard ratio: 1.06, 95% CI 0.42 - 2.71). null null null Conclusion null Sleep-disordered breathing is present in more than half of patients with obstructive HCM in whom septal myectomy is indicated, and is mainly associated with aging, overweight, and male sex. However, SDB does not alter survival following septal myectomy.
#2Jiasuoer Xiaokereti (First Affiliated Hospital of Xinjiang Medical University)H-Index: 1
#3Qingjun Meng (First Affiliated Hospital of Xinjiang Medical University)
Last. Baopeng Tang (First Affiliated Hospital of Xinjiang Medical University)H-Index: 10
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Background Previous studies have proved that low-level vagus nerve stimulation (LLVS) could suppressed acute obstructive sleep apnea (OSA) associated atrial fibrillation (AF). Objective This study mainly investigates the underlying electrophysiological, neural and cardiomyocyte injury mechanisms on acute OSA-induced AF, and testify whether LLVS can attenuate or reverse these remodeling. Methods and results Eighteen mongrel dogs received endotracheal intubation under general anesthesia and random...
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#1Tomas Konecny (SC: University of Southern California)H-Index: 16
#2Michael Khoo (SC: University of Southern California)H-Index: 1
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Abstract Background Current guidelines recommend medications with rate control properties for symptomatic patients with hypertrophic cardiomyopathy (HCM) based on the rationale that lowering heart rate (HR) improves their symptoms. Whether sleep disordered breathing (SDB) is associated with increased HR in HCM patients is not known. Method We diagnosed uncontrolled SDB (oxygen desaturation index ≥5) in consecutive echocardiographically confirmed HCM patients seen at Mayo Clinic, Rochester, and a...
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Background The prevalence of obstructive sleep apnoea (OSA) is high in patients with hypertrophic cardiomyopathy. The effect of septal myectomy on OSA is not clear. This study aimed to examine the association between hypertrophic obstructive cardiomyopathy and OSA before and after septal myectomy. Method We included 85 consecutive patents with a confirmed diagnosis of hypertrophic obstructive cardiomyopathy who underwent septal myectomy. Polysomnography was performed in all patients before and 3...
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Cited By1
#1Jan Konecny (Masaryk University)
#2Thomas Konecny (UF: University of Florida)