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 months after the surgery.
Results
Of the 85 patients, 49 (58%) were diagnosed with OSA. Patients with OSA were significantly
older than those without OSA. The incidence of atrial fibrillation significantly increased
during the perioperative period in patients with OSA (p = 0.03). The severity of OSA
significantly increased 3 months after surgery, as determined by the apnoea–hypopnoea
index (AHI; p < 0.001), obstructive apnoea index (p = 0.024), and hypopnoea index
(p = 0.003), whereas central apnoea index was decreased (p = 0.008). In the multivariate
linear regression analysis, mean oxygen desaturation and time% with SpO2 <90% during sleep before surgery were significantly associated with increased AHI,
independently of body mass index and sex (p = 0.026 and p = 0.007, respectively; adjusted
R2 = 0.365).
Conclusions
The severity of OSA significantly increased 3 months after septal myectomy as determined
by AHI, obstructive apnoea index, and hypopnoea index. Mean oxygen saturation and
time% with SpO2 <90% during sleep before surgery were independently associated with the increase
of AHI. However, the specific mechanism of such deterioration of OSA after septal
myectomy needs to be determined in detail.
Keywords
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Article info
Publication history
Published online: September 18, 2019
Accepted:
May 23,
2019
Received:
January 22,
2019
Identification
Copyright
© 2019 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
