PDF(Pubmed)
Abstract：
UNASSIGNED: Exercise capacity reflects the cardiovascular risk after myocardial infarction (MI). The study aims to evaluate the impact of sleep-disordered breathing (SDB) on exercise capacity after MI.
UNASSIGNED: Consecutive patients referring to outpatient cardiac rehabilitation up to 28 days after MI and participating in the Polish Managed Care after Acute Myocardial Infarction (MC-AMI) program were included. On admission, we assessed the presence and the severity of SDB using the home sleep apnea test (HSAT), patients\' maximum exercise capacity on a treadmill exercise stress test (EST), and a 6-minute walk test (6MWT), as well as the effect of SDB on the results obtained. In the multivariate analysis, we verified the strength of the observed associations concerning age, anthropometric parameters, and left ventricular ejection fraction (LVEF).
UNASSIGNED: A total of 254 patients aged 60.00 (interquartile range 51.00-67.00), including 39 (15.4%) women, with technically adequate HSAT, constituted the study group. Mild SDB was found in 82 (32.3%), moderate in 54 (21.3%), and severe in 51 (20.1%) patients. Among those diagnosed with SDB, obstructive sleep apnea (OSA) was dominant in 167 (89.8%). With the worsening of SDB, the distance in 6MWT and the maximum physical exertion achieved in EST, expressed in metabolic equivalents (METs) and maximal heart rate (MHR), decreased. The linear regression analysis confirmed the following: (1) inversely proportional relationship between the respiratory event index and METs, MHR, and 6MWT distance (p = 0.005, p = 0.008, and p = 0.004), and the maximum apnea duration and MET and 6MWT distance (p = 0.042 and p = 0.002); and (2) directly proportional relationship between mean arterial oxygen saturation ( SpO 2 ) during sleep and MET, MHR, and 6MWT distance (p = 0.019, p = 0.006, and p = 0.013), and minimum SpO 2 and MET and MHR (p = 0.040 and p < 0.001). However, the independent risk factors for impaired exercise capacity, determined using multivariable regression analysis, were age, female sex, higher body mass index (BMI), and decreased LVEF, but not SDB parameters.
UNASSIGNED: SDB negatively impacts exercise capacity after MI. However, the strength of this association may be less pronounced due to the interaction of risk factors common for SDB and impaired exercise capacity, e.g., sex, age, BMI, and LVEF.
UNASSIGNED: Consecutive patients referring to outpatient cardiac rehabilitation up to 28 days after MI and participating in the Polish Managed Care after Acute Myocardial Infarction (MC-AMI) program were included. On admission, we assessed the presence and the severity of SDB using the home sleep apnea test (HSAT), patients\' maximum exercise capacity on a treadmill exercise stress test (EST), and a 6-minute walk test (6MWT), as well as the effect of SDB on the results obtained. In the multivariate analysis, we verified the strength of the observed associations concerning age, anthropometric parameters, and left ventricular ejection fraction (LVEF).
UNASSIGNED: A total of 254 patients aged 60.00 (interquartile range 51.00-67.00), including 39 (15.4%) women, with technically adequate HSAT, constituted the study group. Mild SDB was found in 82 (32.3%), moderate in 54 (21.3%), and severe in 51 (20.1%) patients. Among those diagnosed with SDB, obstructive sleep apnea (OSA) was dominant in 167 (89.8%). With the worsening of SDB, the distance in 6MWT and the maximum physical exertion achieved in EST, expressed in metabolic equivalents (METs) and maximal heart rate (MHR), decreased. The linear regression analysis confirmed the following: (1) inversely proportional relationship between the respiratory event index and METs, MHR, and 6MWT distance (p = 0.005, p = 0.008, and p = 0.004), and the maximum apnea duration and MET and 6MWT distance (p = 0.042 and p = 0.002); and (2) directly proportional relationship between mean arterial oxygen saturation ( SpO 2 ) during sleep and MET, MHR, and 6MWT distance (p = 0.019, p = 0.006, and p = 0.013), and minimum SpO 2 and MET and MHR (p = 0.040 and p < 0.001). However, the independent risk factors for impaired exercise capacity, determined using multivariable regression analysis, were age, female sex, higher body mass index (BMI), and decreased LVEF, but not SDB parameters.
UNASSIGNED: SDB negatively impacts exercise capacity after MI. However, the strength of this association may be less pronounced due to the interaction of risk factors common for SDB and impaired exercise capacity, e.g., sex, age, BMI, and LVEF.
摘要：
■运动能力反映了心肌梗死（MI）后的心血管风险。该研究旨在评估MI后睡眠呼吸紊乱（SDB）对运动能力的影响。
■包括在MI后28天内连续进行门诊心脏康复并参加急性心肌梗死后波兰管理护理（MC-AMI）计划的患者。一入场,我们使用家庭睡眠呼吸暂停试验（HSAT）评估SDB的存在和严重程度，患者在跑步机运动压力测试（EST）上的最大运动能力，和6分钟步行测试（6MWT），以及SDB对所得结果的影响。在多变量分析中，我们验证了观察到的关于年龄的关联的强度，人体测量参数,左心室射血分数(LVEF)。
■总共254名患者，年龄为60.00岁（四分位距51.00-67.00），包括39名(15.4%)女性，有了技术上足够的HSAT，组成了研究小组。82例(32.3%)发现轻度SDB，54名中等（21.3%），51例（20.1%）患者严重。在那些被诊断为SDB的人中，阻塞性睡眠呼吸暂停（OSA）占主导地位的有167人（89.8％）。随着SDB的恶化，6MWT的距离和EST达到的最大体力消耗，以代谢当量（MET）和最大心率（MHR）表示，decreased.线性回归分析证实了以下结论:(1)呼吸事件指数与METs成反比关系,MHR,和6MWT距离（p=0.005，p=0.008和p=0.004），以及最大呼吸暂停持续时间和MET和6MWT距离（p=0.042和p=0.002）；（2）睡眠期间平均动脉血氧饱和度（SpO2）与MET之间成正比关系，MHR,和6MWT距离（p=0.019，p=0.006和p=0.013），和最小SpO2、MET和MHR(p=0.040和p<0.001)。然而,运动能力受损的独立危险因素，使用多变量回归分析确定，是年龄，女性性别,较高的体重指数（BMI），LVEF降低，但不是SDB参数。
■SDB对MI后的运动能力产生负面影响。然而,由于SDB常见的风险因素和运动能力受损的相互作用，这种关联的强度可能不太明显，例如，性别,年龄,BMI,LVEF。
■包括在MI后28天内连续进行门诊心脏康复并参加急性心肌梗死后波兰管理护理（MC-AMI）计划的患者。一入场,我们使用家庭睡眠呼吸暂停试验（HSAT）评估SDB的存在和严重程度，患者在跑步机运动压力测试（EST）上的最大运动能力，和6分钟步行测试（6MWT），以及SDB对所得结果的影响。在多变量分析中，我们验证了观察到的关于年龄的关联的强度，人体测量参数,左心室射血分数(LVEF)。
■总共254名患者，年龄为60.00岁（四分位距51.00-67.00），包括39名(15.4%)女性，有了技术上足够的HSAT，组成了研究小组。82例(32.3%)发现轻度SDB，54名中等（21.3%），51例（20.1%）患者严重。在那些被诊断为SDB的人中，阻塞性睡眠呼吸暂停（OSA）占主导地位的有167人（89.8％）。随着SDB的恶化，6MWT的距离和EST达到的最大体力消耗，以代谢当量（MET）和最大心率（MHR）表示，decreased.线性回归分析证实了以下结论:(1)呼吸事件指数与METs成反比关系,MHR,和6MWT距离（p=0.005，p=0.008和p=0.004），以及最大呼吸暂停持续时间和MET和6MWT距离（p=0.042和p=0.002）；（2）睡眠期间平均动脉血氧饱和度（SpO2）与MET之间成正比关系，MHR,和6MWT距离（p=0.019，p=0.006和p=0.013），和最小SpO2、MET和MHR(p=0.040和p<0.001)。然而,运动能力受损的独立危险因素，使用多变量回归分析确定，是年龄，女性性别,较高的体重指数（BMI），LVEF降低，但不是SDB参数。
■SDB对MI后的运动能力产生负面影响。然而,由于SDB常见的风险因素和运动能力受损的相互作用，这种关联的强度可能不太明显，例如，性别,年龄,BMI,LVEF。
