Nature and Science of Sleep (Oct 2019)
Poor Sleep Quality Associated With High Risk Of Ventricular Tachycardia After Acute Myocardial Infarction
Abstract
Shipeng Wang,1,2,* Hui Gao,3,* Zewen Ru,1 Yanan Zou,1 Yilan Li,1 Wei Cao,4 Wei Meng,1 Jihe Li,5 Yuan Yao,1 Yanxiu Zhang,1 Xueyan Lang,1 Yao Zhang1,2 1Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, People’s Republic of China; 2Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin 150086, People’s Republic of China; 3Department of Cardiology, People’ Hospital of Xinzheng, Xinzheng, Henan Province 451150, People’s Republic of China; 4Department of Cardiology, Heilongjiang Provincial Hospital Affiliated to Harbin Institute of Technology, Harbin 150036, People’s Republic of China; 5Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, People’s Republic of China*These authors contributed equally to this workCorrespondence: Shipeng WangDepartment of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Xuefu Road 246#, Nangang District, Harbin 150086, People’s Republic of ChinaTel +86 13654504286Fax +86 86296225Email [email protected]: Sleep disorders (SDs) are usually associated with an increase in frequency of ventricular tachycardia (VT). However, the relationship between SDs and the prevalence of VT within the first week of acute myocardial infarction (AMI) remains unclear. This study aimed to evaluate their associations and potential mechanisms.Methods: This structured questionnaire-based cross-sectional study enrolled 303 patients with AMI from a hospital in northern China. Pittsburgh Sleep Quality Index (PSQI) was used to determine sleep quality of subjects. Heart rate variability (HRV) of patients was investigated by ambulatory electrocardiography recorders. Enzyme-linked immunosorbent assay was used to measure the plasma levels of catecholamine in a subgroup including 80 patients with AMI.Results: After adjusting to basic cardiovascular characteristics, results of multivariate logistic regression demonstrated that the global PSQI score and its main components were positively associated with VT prevalence in inpatients with AMI. There were significantly different HRV parameters interpreted as autonomic nerve activity in two groups of AMI patients with different sleep quality. In addition, we found the influence of sleep quality on plasma concentrations of adrenaline and norepinephrine in AMI patients.Conclusion: Sleep status was significantly associated with the initiation of VT within the first week of AMI, probably due to the effect of SDs on sympathetic nerve activity. Amelioration of sleep quality and sympathetic hyperactivity may be prospective strategy to curb arrhythmias after AMI.Keywords: ventricular tachycardia, acute myocardial infarction, sleep disorders, heart rate variability, catecholamine
