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Coronary artery disease is a common and serious disease, the leading cause of death worldwide. Obstructive sleep apnea syndrome (OSAS) is common and often under-diagnosed in coronary artery disease where it could be involved in the pathophysiology and perhaps prognosis. The entanglement of the two pathologies is actually quite well known, in particular the consequences of one over the other just beginning to be studied. Understanding the pathophysiology through new imaging modalities should improve the management of patients to propose new approaches.
"SAS-IDM" is an interventional and prospective study conducted at the University Hospital of Montpellier. Patients will be divided in three groups depending of the results of the polysomnography: 1/ AHI < 5/h: normal, without OSA ; 2/ 5/h ≤ AHI < 30/h: mild or moderate OSA ; 3/ IAH ≥ 30/h: severe OSA. A treatment by CPAP will be proposed to patients of the group "severe OSA".
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Without Obstructive Sleep Apnea (syndrome) | Other | Subjects will be randomized after the results of the polysomnography (21st day ± 10) in one of this three groups |
|
| Mild or moderate Obstructive Sleep Apnea (syndrome) | Other | Subjects will be randomized after the results of the polysomnography (21st day ± 10) in one of this three groups |
|
| Severe Obstructive Sleep Apnea (syndrome) | Other | Subjects will be randomized after the results of the polysomnography (21st day ± 10) in one of this three groups |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Without Obstructive Sleep Apnea (syndrome) | Other |
| ||
| Mild or moderate Obstructive Sleep Apnea (syndrome) |
| Measure | Description | Time Frame |
|---|---|---|
| Changes in diameter (mm) and end diastolic and systolic LV volumes (mL) at 6 months of acute MI among a group of patients without OSA (AHI <5 / h) and a group of patients with mild to moderate OSA (AHI between 5 and 30 / h) | 6 months of acute MI | |
| Transmural enhancement (%) at 6 months of acute MI among a group of patients without OSA (AHI <5 / h) and a group of patients with mild to moderate OSA (AHI between 5 and 30 / h) | 6 months of acute MI | |
| Thickness of the LV wall (mm) at 6 months of acute MI among a group of patients without OSA (AHI <5 / h) and a group of patients with mild to moderate OSA (AHI between 5 and 30 / h) | 6 months of acute MI | |
| Presence no reflow at 6 months of acute MI among a group of patients without OSA (AHI <5 / h) and a group of patients with mild to moderate OSA (AHI between 5 and 30 / h) | 6 months of acute MI |
| Measure | Description | Time Frame |
|---|---|---|
| The difference in cardiac remodeling in cardiac MRI at 6 months between the three diagnostic categories | At 6 months after inclusion | |
| The difference in cardiac remodeling in cardiac MRI between the date of inclusion and 6 months between diagnostic categories. |
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Inclusion Criteria:
Exclusion Criteria:
Patients for whom CPAP equipment has demonstrated its usefulness regardless of cardiovascular context
Contraindication to achieve cardiac MRI (primary endpoint):
Mild infarction (rate of late enhancement MRI in less than or equal to 4 segments of 17 during the first MRI)
Patient previously treated with CPAP prior MI or already experienced with sleep apnea syndrome.
SAS whose central part is predominantly (> 50%)
General
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hôpital Arnaud de Villeneuve - CHU de Montpellier | Montpellier | 34295 | France |
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| Other |
|
| Severe Obstructive Sleep Apnea (syndrome) | Other |
|
| CPAP | Device |
|
| Between the date of inclusion and 6 months |
| The difference of left ventricular remodeling in cardiac MRI between the date of inclusion and 6 months in the severe OSA group based on the assumption (good compliance and effectiveness of PPC or not) | Between the date of inclusion and 6 months |
| The occurrence of cardiovascular events during the first year following the IDM depending on the initial AHI index. | Between the date of inclusion and one year |
| ID | Term |
|---|---|
| D013577 | Syndrome |
| D020257 | Ventricular Remodeling |
| ID | Term |
|---|---|
| D004194 | Disease |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D020763 | Pathological Conditions, Anatomical |
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