Skip to main content
Erschienen in: Sleep and Breathing 4/2022

01.06.2022 | Sleep Breathing Physiology and Disorders • Original Article

Effects of obstructive sleep apnea hypopnea syndrome on postoperative complications in patients who undergo off-pump coronary artery bypass grafting

verfasst von: Mingxin Gao, Pengcheng Wang, Tian Tang, Wenyuan Yu, Yang Yu, Yongxiang Wei

Erschienen in: Sleep and Breathing | Ausgabe 4/2022

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To investigate the prevalence of obstructive sleep apnea hypopnea syndrome (OSAHS) in patients undergoing off-pump coronary artery bypass grafting (OPCABG) and analyze the effects of OSAHS on the incidence of post-OPCABG complications, length of stay in intensive care unit (ICU) and hospitalization, and hospital expense.

Materials and methods

This prospective study included patients undergoing OPCABG at Beijing An Zhen hospital from January 2018 to December 2018. OSAHS was diagnosed by using a portable sleep monitor before surgery.

Results

Among 74 patients, the prevalence of OSAHS and moderate to severe OSAHS (apnea hypopnea index (AHI) ≥ 15) was 70% and 53%, respectively. Compared with the no to mild OSAHS group (AHI < 15), the moderate to severe OSAHS group presented a lower ejection fraction (P = 0.013). Between these two groups, the incidence of post-OPCABG complications; the duration of intubation, ICU stay, and hospitalization; and the hospital expense did not differ. Notably, the ejection fraction was significantly negatively correlated with the duration of ICU stay and hospital expense.

Conclusions

Patients undergoing OPCABG with severe OSAHS are likely to exhibit a low ejection fraction and poor heart function, which may require a longer ICU stay and incur higher hospital expenses.
Literatur
1.
Zurück zum Zitat McEvoy RD, Antic NA, Heeley E, Luo Y, Ou Q, Zhang X et al (2016) SAVE Investigators and Coordinators. CPAP for prevention of cardiovascular events in obstructive sleep apnea. N Engl J Med 375:919–31CrossRefPubMed McEvoy RD, Antic NA, Heeley E, Luo Y, Ou Q, Zhang X et al (2016) SAVE Investigators and Coordinators. CPAP for prevention of cardiovascular events in obstructive sleep apnea. N Engl J Med 375:919–31CrossRefPubMed
2.
Zurück zum Zitat Sforza E, Millasseau S, Hupin D, Barthélémy JC, Roche F (2019) Arterial stiffness alteration and obstructive sleep apnea in an elderly cohort free of cardiovascular event history: the PROOF cohort study. Sleep Breath 23(1):201–208CrossRefPubMed Sforza E, Millasseau S, Hupin D, Barthélémy JC, Roche F (2019) Arterial stiffness alteration and obstructive sleep apnea in an elderly cohort free of cardiovascular event history: the PROOF cohort study. Sleep Breath 23(1):201–208CrossRefPubMed
3.
Zurück zum Zitat Yu Y, Gao MX, Wang C, Gu CX (2012) Bipolar radiofrequency ablation for left ventricular aneurysm related ventricular arrhythmia. J Thorac Cardiovasc Surg 144:101–102CrossRef Yu Y, Gao MX, Wang C, Gu CX (2012) Bipolar radiofrequency ablation for left ventricular aneurysm related ventricular arrhythmia. J Thorac Cardiovasc Surg 144:101–102CrossRef
4.
Zurück zum Zitat Amra B, Niknam N, Sadeghi MM, Rabbani M, Fietze I, Penzel T (2014) Obstructive sleep apnea and postoperative complications in patients undergoing coronary artery bypass graft surgery: a need for preventive strategies. Int J Prev Med 5:1446–1451PubMedPubMedCentral Amra B, Niknam N, Sadeghi MM, Rabbani M, Fietze I, Penzel T (2014) Obstructive sleep apnea and postoperative complications in patients undergoing coronary artery bypass graft surgery: a need for preventive strategies. Int J Prev Med 5:1446–1451PubMedPubMedCentral
5.
Zurück zum Zitat Qaddoura A, Kabali C, Drew D, van Oosten EM, Michael KA, Redfearn DP et al (2014) Obstructive sleep apnea as a predictor of atrial fibrillation after coronary artery bypass grafting: a systematic review and meta-analysis. Can J Cardiol 30:1516–1522CrossRefPubMed Qaddoura A, Kabali C, Drew D, van Oosten EM, Michael KA, Redfearn DP et al (2014) Obstructive sleep apnea as a predictor of atrial fibrillation after coronary artery bypass grafting: a systematic review and meta-analysis. Can J Cardiol 30:1516–1522CrossRefPubMed
7.
Zurück zum Zitat Gao M, Fan K, Yu W, Liu H, Wei Y, Yu Y (2007) The effects of high-sensitivity C-reactive protein on the clinical outcomes in obstructive sleep apnea patients undergoing off-pump coronary artery bypass grafting. BMC Cardiovasc Disord 21:366CrossRef Gao M, Fan K, Yu W, Liu H, Wei Y, Yu Y (2007) The effects of high-sensitivity C-reactive protein on the clinical outcomes in obstructive sleep apnea patients undergoing off-pump coronary artery bypass grafting. BMC Cardiovasc Disord 21:366CrossRef
8.
Zurück zum Zitat Uchôa CH, Danzi-Soares Nde J, Nunes FS, de Souza AA, Nerbass FB, Pedrosa RP et al (2015) Impact of OSA on cardiovascular events after coronary artery bypass surgery. Chest 147:1352–1360CrossRefPubMed Uchôa CH, Danzi-Soares Nde J, Nunes FS, de Souza AA, Nerbass FB, Pedrosa RP et al (2015) Impact of OSA on cardiovascular events after coronary artery bypass surgery. Chest 147:1352–1360CrossRefPubMed
9.
Zurück zum Zitat Ward NR, Roldao V, Cowie MR, Rosen SD, McDonagh TA, Simonds AK et al (2013) The effect of respiratory scoring on the diagnosis and classification of sleep disordered breathing in chronic heart failure. Sleep 36:1341–1348CrossRefPubMedPubMedCentral Ward NR, Roldao V, Cowie MR, Rosen SD, McDonagh TA, Simonds AK et al (2013) The effect of respiratory scoring on the diagnosis and classification of sleep disordered breathing in chronic heart failure. Sleep 36:1341–1348CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Danzi-Soares NJ, Genta PR, Nerbass FB, Pedrosa RP, Soares FS, César LA et al (2012) Obstructive sleep apnea is common among patients referred for coronary artery bypass grafting and can be diagnosed by portable monitoring. Coron Artery Dis 23:31–38CrossRefPubMed Danzi-Soares NJ, Genta PR, Nerbass FB, Pedrosa RP, Soares FS, César LA et al (2012) Obstructive sleep apnea is common among patients referred for coronary artery bypass grafting and can be diagnosed by portable monitoring. Coron Artery Dis 23:31–38CrossRefPubMed
11.
Zurück zum Zitat van Oosten EM, Hamilton A, Petsikas D, Payne D, Redfearn DP, Zhang S et al (2014) Effect of preoperative obstructive sleep apnea on the frequency of atrial fibrillation after coronary artery bypass grafting. Am J Cardiol 113:919–923CrossRefPubMed van Oosten EM, Hamilton A, Petsikas D, Payne D, Redfearn DP, Zhang S et al (2014) Effect of preoperative obstructive sleep apnea on the frequency of atrial fibrillation after coronary artery bypass grafting. Am J Cardiol 113:919–923CrossRefPubMed
12.
Zurück zum Zitat Lee W, Nagubadi S, Kryger MH, Mokhlesi B (2008) Epidemiology of obstructive sleep apnea: a population-based perspective. Expert Rev Respir Med 2:349–364CrossRefPubMedPubMedCentral Lee W, Nagubadi S, Kryger MH, Mokhlesi B (2008) Epidemiology of obstructive sleep apnea: a population-based perspective. Expert Rev Respir Med 2:349–364CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S (1993) The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 328:1230–1235CrossRefPubMed Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S (1993) The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 328:1230–1235CrossRefPubMed
14.
Zurück zum Zitat Cauley JA, Gutai JP, Glynn NW, Paternostro-Bayles M, Cottington E, Kuller LH (1994) Serum estrone concentrations and coronary artery disease in postmenopausal women. Arterioscler Thromb 14:14–18CrossRefPubMed Cauley JA, Gutai JP, Glynn NW, Paternostro-Bayles M, Cottington E, Kuller LH (1994) Serum estrone concentrations and coronary artery disease in postmenopausal women. Arterioscler Thromb 14:14–18CrossRefPubMed
15.
Zurück zum Zitat Simon JA, Hunninghake DB, Agarwal SK, Lin F, Cauley JA, Ireland CC et al (2001) Effect of estrogen plus progestin on risk for biliary tract surgery in postmenopausal women with coronary artery disease. The heart and estrogen/progestin replacement study. Ann Intern Med 135:493–501CrossRefPubMed Simon JA, Hunninghake DB, Agarwal SK, Lin F, Cauley JA, Ireland CC et al (2001) Effect of estrogen plus progestin on risk for biliary tract surgery in postmenopausal women with coronary artery disease. The heart and estrogen/progestin replacement study. Ann Intern Med 135:493–501CrossRefPubMed
16.
Zurück zum Zitat Mikami M, Tatsumi K, Kimura H, Honda Y, Kuriyama T (1989) Respiration effect of synthetic progestin in small doses in normal men. Chest 96:1073–1075CrossRefPubMed Mikami M, Tatsumi K, Kimura H, Honda Y, Kuriyama T (1989) Respiration effect of synthetic progestin in small doses in normal men. Chest 96:1073–1075CrossRefPubMed
17.
Zurück zum Zitat Whittle AT, Marshall I, Mortimore IL, Wraith PK, Sellar RJ, Douglas NJ (1999) Neck soft tissue and fat distribution: comparison between normal men and women by magnetic resonance imaging. Thorax 54:323–328CrossRefPubMedPubMedCentral Whittle AT, Marshall I, Mortimore IL, Wraith PK, Sellar RJ, Douglas NJ (1999) Neck soft tissue and fat distribution: comparison between normal men and women by magnetic resonance imaging. Thorax 54:323–328CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Ali SF, Smith EE, Reeves MJ, Zhao X, Xian Y, Hernandez AF et al (2015) Smoking paradox in patients hospitalized with coronary artery disease or acute ischemic stroke: findings from Get with the Guidelines. Circ Cardiovasc Qual Outcomes 8:S73–S80CrossRefPubMed Ali SF, Smith EE, Reeves MJ, Zhao X, Xian Y, Hernandez AF et al (2015) Smoking paradox in patients hospitalized with coronary artery disease or acute ischemic stroke: findings from Get with the Guidelines. Circ Cardiovasc Qual Outcomes 8:S73–S80CrossRefPubMed
19.
Zurück zum Zitat Malerba M, Montuschi P (2012) Non-invasive biomarkers of lung inflammation in smoking subjects. Curr Med Chem 19:187–196CrossRefPubMed Malerba M, Montuschi P (2012) Non-invasive biomarkers of lung inflammation in smoking subjects. Curr Med Chem 19:187–196CrossRefPubMed
20.
Zurück zum Zitat Taillé C, Rouvel-Tallec A, Stoica M, Danel C, Dehoux M, Marin-Esteban V et al (2016) Obstructive sleep apnoea modulates airway inflammation and remodelling in severe asthma. PLoS One 11:e0150042CrossRefPubMedPubMedCentral Taillé C, Rouvel-Tallec A, Stoica M, Danel C, Dehoux M, Marin-Esteban V et al (2016) Obstructive sleep apnoea modulates airway inflammation and remodelling in severe asthma. PLoS One 11:e0150042CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Wang J, Yu W, Gao M, Zhang F, Gu C, Yu Y et al (2015) Impact of obstructive sleep apnea syndrome per se on endothelial function, arterial stiffening, and serum inflammatory markers: an update meta-analysis and meta-regression of 18 studies. JAHA 4:e002454 Wang J, Yu W, Gao M, Zhang F, Gu C, Yu Y et al (2015) Impact of obstructive sleep apnea syndrome per se on endothelial function, arterial stiffening, and serum inflammatory markers: an update meta-analysis and meta-regression of 18 studies. JAHA 4:e002454
22.
Zurück zum Zitat Hall AB, Ziadi MC, Leech JA, Chen SY, Burwash IG, Renaud J et al (2014) Effects of short-term continuous positive airway pressure on myocardial sympathetic nerve function and energetics in patients with heart failure and obstructive sleep apnea: a randomized study. Circulation 130:892–901CrossRefPubMed Hall AB, Ziadi MC, Leech JA, Chen SY, Burwash IG, Renaud J et al (2014) Effects of short-term continuous positive airway pressure on myocardial sympathetic nerve function and energetics in patients with heart failure and obstructive sleep apnea: a randomized study. Circulation 130:892–901CrossRefPubMed
23.
Zurück zum Zitat Bitter T, Fox H, Dimitriadis Z, Niedermeyer J, Prib N, Prinz C et al (2014) Circadian variation of defibrillator shocks in patients with chronic heart failure: the impact of Cheyne-Stokes respiration and obstructive sleep apnea. Int J Cardiol 176:1033–1035CrossRefPubMed Bitter T, Fox H, Dimitriadis Z, Niedermeyer J, Prib N, Prinz C et al (2014) Circadian variation of defibrillator shocks in patients with chronic heart failure: the impact of Cheyne-Stokes respiration and obstructive sleep apnea. Int J Cardiol 176:1033–1035CrossRefPubMed
24.
Zurück zum Zitat Li S, Feng J, Wei S, Qian X, Cao J, Chen B (2016) Delayed neutrophil apoptosis mediates intermittent hypoxia-induced progressive heart failure in pressure-overloaded rats. Sleep Breath 20:95–102CrossRefPubMed Li S, Feng J, Wei S, Qian X, Cao J, Chen B (2016) Delayed neutrophil apoptosis mediates intermittent hypoxia-induced progressive heart failure in pressure-overloaded rats. Sleep Breath 20:95–102CrossRefPubMed
25.
Zurück zum Zitat Gami AS, Hodge DO, Herges RM, Olson EJ, Nykodym J, Kara T et al (2007) Obstructive sleep apnea, obesity, and the risk of incident atrial fibrillation. J Am Coll Cardiol 49:565–571CrossRefPubMed Gami AS, Hodge DO, Herges RM, Olson EJ, Nykodym J, Kara T et al (2007) Obstructive sleep apnea, obesity, and the risk of incident atrial fibrillation. J Am Coll Cardiol 49:565–571CrossRefPubMed
26.
Zurück zum Zitat Miller JD, Aronis KN, Chrispin J, Patil KD, Marine JE, Martin SS et al (2015) Obesity, exercise, obstructive sleep apnea, and modifiable atherosclerotic cardiovascular disease risk factors in atrial fibrillation. J Am Coll Cardiol 66:2899–2906CrossRefPubMed Miller JD, Aronis KN, Chrispin J, Patil KD, Marine JE, Martin SS et al (2015) Obesity, exercise, obstructive sleep apnea, and modifiable atherosclerotic cardiovascular disease risk factors in atrial fibrillation. J Am Coll Cardiol 66:2899–2906CrossRefPubMed
27.
Zurück zum Zitat Wong JK, Maxwell BG, Kushida CA, Sainani KL, Lobato RL, Woo YJ et al (2015) Obstructive sleep apnea is an independent predictor of postoperative atrial fibrillation in cardiac surgery. J Cardiothorac Vasc Anesth 29:1140–1147CrossRefPubMed Wong JK, Maxwell BG, Kushida CA, Sainani KL, Lobato RL, Woo YJ et al (2015) Obstructive sleep apnea is an independent predictor of postoperative atrial fibrillation in cardiac surgery. J Cardiothorac Vasc Anesth 29:1140–1147CrossRefPubMed
28.
Zurück zum Zitat Mooe T, Gullsby S, Rabben T, Eriksson P (1996) Sleep-disordered breathing: a novel predictor of atrial fibrillation after coronary artery bypass surgery. Coron Artery Dis 7:475–478CrossRefPubMed Mooe T, Gullsby S, Rabben T, Eriksson P (1996) Sleep-disordered breathing: a novel predictor of atrial fibrillation after coronary artery bypass surgery. Coron Artery Dis 7:475–478CrossRefPubMed
29.
Zurück zum Zitat Abuelo JG (2015) Low dialysate potassium concentration: an overrated risk factor for cardiac arrhythmia? Semin Dial 28:266–275CrossRefPubMed Abuelo JG (2015) Low dialysate potassium concentration: an overrated risk factor for cardiac arrhythmia? Semin Dial 28:266–275CrossRefPubMed
30.
Zurück zum Zitat Huang B, Zhou X, Wang Z, Wang S, Yu L, Jiang H (2015) Extracardiac autonomic modulations: potential therapeutic options for myocardial ischemia-induced ventricular arrhythmia. Int J Cardiol 188:45–46CrossRefPubMed Huang B, Zhou X, Wang Z, Wang S, Yu L, Jiang H (2015) Extracardiac autonomic modulations: potential therapeutic options for myocardial ischemia-induced ventricular arrhythmia. Int J Cardiol 188:45–46CrossRefPubMed
31.
Zurück zum Zitat Raghuram A, Clay R, Kumbam A, Tereshchenko LG, Khan A (2014) A systematic review of the association between obstructive sleep apnea and ventricular arrhythmias. J Clin Sleep Med 10:1155–1160CrossRefPubMedPubMedCentral Raghuram A, Clay R, Kumbam A, Tereshchenko LG, Khan A (2014) A systematic review of the association between obstructive sleep apnea and ventricular arrhythmias. J Clin Sleep Med 10:1155–1160CrossRefPubMedPubMedCentral
32.
Zurück zum Zitat Wang J, Yu W, Gao M, Zhang F, Li Q, Gu C et al (2015) Continuous positive airway pressure treatment reduce cardiovascular death and non-fatal cardiovascular events in patients with obstructive sleep apnea: a meta-analysis of 11 studies. Int J Cardiol 191:218–231CrossRef Wang J, Yu W, Gao M, Zhang F, Li Q, Gu C et al (2015) Continuous positive airway pressure treatment reduce cardiovascular death and non-fatal cardiovascular events in patients with obstructive sleep apnea: a meta-analysis of 11 studies. Int J Cardiol 191:218–231CrossRef
Metadaten
Titel
Effects of obstructive sleep apnea hypopnea syndrome on postoperative complications in patients who undergo off-pump coronary artery bypass grafting
verfasst von
Mingxin Gao
Pengcheng Wang
Tian Tang
Wenyuan Yu
Yang Yu
Yongxiang Wei
Publikationsdatum
01.06.2022
Verlag
Springer International Publishing
Erschienen in
Sleep and Breathing / Ausgabe 4/2022
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-022-02649-4

Weitere Artikel der Ausgabe 4/2022

Sleep and Breathing 4/2022 Zur Ausgabe

Sleep Breathing Physiology and Disorders • Short Communication

Mandibular advancement device therapy in patients with epiglottic collapse

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Feuchte Makuladegeneration zusätzlich bestrahlen?

24.06.2024 Makuladegeneration Nachrichten

Die Zahl der erforderlichen Injektionen in den Glaskörper lässt sich bei Personen mit feuchter Makuladegeneration offenbar deutlich reduzieren, indem man die VEGF-Blocker-Therapie durch eine stereotaktische Bestrahlung ergänzt.

Bariatrische Chirurgie vs. GLP-1-Rezeptoragonisten: Wer hat die Nase vorn?

24.06.2024 Typ-2-Diabetes Nachrichten

In einer israelischen Studie profitierte eine Gruppe von Diabetes-Patienten mit Fettleibigkeit in puncto Mortalität ganz besonders von der Adipositaschirurgie: Patienten, die seit weniger als zehn Jahren an einem Diabetes mellitus Typ 2 erkrankt waren. Lag ein Diabetes schon länger vor, dann waren GLP-1-Rezeporagonisten ebenso wirksam.

Retinopathie-Screening: Beinahe jeder zweite Typ-1-Diabetiker hat Netzhautveränderungen

24.06.2024 Diabetische Retinopathie Nachrichten

Wie wichtig es gerade für Menschen mit Diabetes Typ 1 ist, regelmäßig zur augenärztlichen Untersuchung zu gehen, haben erst kürzlich wieder Daten aus Dänemark hervorgehoben. Drei Faktoren scheinen für ein besonders hohes Retinopathie-Risiko zu stehen.

Rektumkarzinom: Häufiger Komplettresponse mit totaler neoadjuvanter Therapie

24.06.2024 Rektumkarzinom Nachrichten

Drei Varianten der totalen neoadjuvanten Therapie ermöglichen bei lokal fortgeschrittenem Rektumkarzinom häufiger eine pathologische Komplettresponse als eine einfache neoadjuvante Radiochemotherapie. Dafür sprechen Resultate einer Netzwerkmetaanalyse.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.