Occurrence of Coronary Collateral Vessels in Patients With Sleep Apnea and Total Coronary Occlusion

Background: Obstructive sleep apnea (OSA) is thought to act as a coronary risk factor. There is emerging evidence that intermittent phases of hypoxia might contribute to alterations of the cardiovascular system. We hypothesized that OSA syndrome (OSAS) might be accompanied by an increased coronary collateral vessel (CCV) development in patients with total coronary, occlusion. Methods: Thirty-four patients with total coronary occlusions were classified according to the apnea-hypopnea index (AHI) (OSAS: AHI > 10/h; non-OSAS: AHI < 10/h). CCVs were scored by visual analysis and were analyzed according to the Cohen and Rentrop grading system. Results: There was no significant discrepancy between the groups concerning the prevalence of age, gender, the presence of hypertension, smoking, or diabetes mellitus. There was no difference in left ventricular systolic function (ejection fraction 53% +/- 20% vs 61% +/- 20%, P = .29) or left ventricular end-diastolic pressure (22.6 +/- 8.5 mm Hg vs 18.5 +/- 7.7 mm Hg, P = .41). OSAS showed a higher Rentrop score compared with non-OSAS (1.61 +/- 1.2 vs 2.4 +/- 0.7, P = .02). Conclusions: These findings suggest that CCV development is augmented in patients with OSA. CHEST 2010; 137(3):516-520