Poor Sleep Quality Associated With High Risk Of Ventricular Tachycardia After Acute Myocardial Infarction

Figures & data

Table 1 Characteristics Of The Study Population According To Sleep Quality

	Poor Sleep Quality (n=147)	Good Sleep Quality (n=156)	P value
Age (year)	60.12 (11.24)	59.12 (11.44)	0.440
Male (%)	61.2	67.3	0.269
Hypertension (%)	50.7	47.2	0.547
Diabetes (%)	28.7	30.7	0.707
Medication
β-blocker (%)	15.4	12.9	0.526
ACE-I/ARB (%)	14.7	16.0	0.766
Amiodarone (%)	2.2	1.2	0.662
Anterior AMI (%)	52.2	46.6	0.337
QTc (ms)	446.85±33.18	452.21±36.87	0.197
EF (%)	59.0 (8.4)	61.0 (7)	0.271
Ischemic times (h)	5.0 (5.38)	5.0 (4.0)	0.558
LVEDD (mm)	45.6 (5.63)	45.2 (5.4)	0.996

Notes: Data are presented as mean ± s.d, medians with IQR or number (%). The χ² statistical test or Fisher’s exact test for nominal variables and T or Mann–Whitney U-test for continuous variables were performed to assess whether there were significant differences between the groups with and without sleep disorder.

Abbreviations: ACE-I, angiotensin-converting-enzyme inhibitor; ARB, angiotensin receptor blocker; QTc, corrected QT intervals; EF, ejection fraction; LVEDD, left ventricular end-diastolic internal diameter; β-blocker, beta-receptor antagonist.

Table 2 Prevalence And Odds Ratio Of VT After AMI By PSQI And Its Components

	Score	n	Prevalence %	OR	95% CI	P value
Global PSQI score	≤5	156	16.7	1.00	(Reference)
	≥6	147	30.6	1.98	1.11–3.50	<0.05
Subjective sleep quality	0	110	14.5		(Reference)
	1	95	25.3	2.34	1.12–4.92	<0.05
	2	54	29.6	2.52	1.11–5.71	<0.05
	3	44	34.1	2.82	1.20–6.64	<0.05
Sleep latency	0	132	18.2		(Reference)
	1	96	25.0	1.45	0.74–2.80	0.277
	2	39	33.3	1.60	0.68–3.72	0.281
	3	36	27.8	1.48	0.61–3.61	0.388
Sleep duration	0	111	13.5		(Reference)
	1	83	26.5	2.58	1.20–5.55	<0.05
	2	67	28.4	2.87	1.28–6.42	<0.05
	3	42	35.7	3.34	1.40–7.95	<0.01
Habitual sleep efficiency	0	130	16.9		(Reference)
	1	76	26.3	1.67	0.81–3.44	0.169
	2	54	29.6	1.92	0.88–4.17	0.100
	3	43	30.2	2.10	0.92–4.80	0.079
Sleep disturbance	0	125	14.4		(Reference)
	1	106	25.5	2.12	1.06–4.22	<0.05
	2	39	35.9	2.94	1.23–7.01	<0.05
	3	33	36.4	3.28	1.32–9.10	<0.05
Use of sleep medication	0	273	22.0		(Reference)
	⩾1	30	36.7	2.05	0.88–4.77	0.096
Daytime dysfunction	0	147	14.3		(Reference)
	1	78	30.8	2.63	1.30–5.33	<0.01
	2	47	31.9	2.91	1.29–6.57	<0.05
	3	31	35.5	3.17	1.29–7.81	<0.05

Notes: Data are presented as adjusted odds ratio (95% confidence interval) for the prevalence of VT after AMI. Logistic regression analysis was conducted after adjusted for age, gender, hypertension, diabetes, history of medication, location of AMI, EF, QTc, ischemic times, LVEDD.

Abbreviations: CI, confidence interval; OR, odds ratio; PSQI, Pittsburgh sleep quality index.

Table 3 Heart Rate Variability Indices Of Participants Grouped According To Their Sleep Quality

Parameters	Poor Sleep Quality (n=147)	Good Sleep Quality (n=156)	P value
AHR (beats/min)	75.08±13.56	72.50±10.52	<0.05
SDNN (ln ms)	4.36±0.35	4.39±0.35	0.529
SDANN (ln ms)	4.18±0.38	4.22±0.38	0.342
rMSDD (ln ms)	2.97±0.59	3.10±0.52	<0.05
SDNNi ms	40.0 (23)	43.5 (21)	0.290
pNN 50%	1.0 (4)	1.5 (4)	0.150
TP (ln ms^2)	9.89±0.82	10.00±0.74	0.175
HF (ln ms^2)	5.33±1.10	5.58±1.06	0.050
LF (ln ms^2)	6.90±0.76	6.66±0.83	<0.01
LF/HF (ln)	1.43±0.83	1.14±0.75	<0.01
vLF (ln ms^2)	8.06±0.83	8.22±0.82	0.103
uLF (ln ms^2)	9.67±0.88	9.72±0.83	0.574

Notes: Data are presented as mean ± s.d, medians with IQR or number (%). The χ² statistical test for nominal variables and T or Mann–Whitney U-test for continuous variables were performed.

Abbreviations: AHR, 24 hr average heart rates; SDNN, the standard deviation of mean NN; standard deviation of all RR intervals; SDANN, the standard deviation of all 5 min mean RR intervals; rMSSD, root-mean-square of the successive RR interval difference; SDNNi, the mean of the standard deviation of all normal RR intervals for all 5-min segments; pNN50, the percentage of >50 ms differences between adjacent NN; TP, total power (sum of VLF, LF and HF); LF, low frequency power; HP, high frequency power; vLF, very low frequency power; uLF, ultra-low-frequency; LF/HF, the ratio of low to high frequency power; ln, natural logarithm.

Table 4 Baseline Characteristics And The Plasma Level Of Catecholamine Of The Study Population

Overall (n=80)	Poor Sleep Quality (n=40)	Good Sleep Quality (n=40)	P value
Age (year)	57.68±12.57	54.93±10.40	0.290
Male (%)	65.0	62.5	0.816
Hypertension (%)	50.0	55.0	0.639
Diabetes (%)	37.5	32.5	0.707
Medication
β-blocker (%)	15.0%	17.5%	0.762
ACE-I /ARB (%)	17.5%	20.5%	0.766
Amiodarone (%)	2.5%	5.0%	1.000
Anterior AMI (%)	45.0	40.0	0.651
EF (%)	60.0 (3.75)	60.5 (6.75)	0.908
ischemic times (h)	3.5 (3.0)	4.0 (4.0)	0.577
LVEDD (mm)	44.6 (5.17)	43.8 (5.92)	0.881
NE (nmol/L)	2.78±0.73	2.31±0.89	<0.05
E (nmol/L)	0.29±0.15	0.22±0.14	<0.05
DA (nmol/L)	0.37±0.18	0.40±0.23	0.518

Notes: Data are presented as mean±s.d, median (quartile spacing) or number (%). The χ² statistical test or Fisher’s exact test for nominal variables and T or Mann–Whitney U-test for continuous variables were performed to assess whether there were significant differences between the groups with and without sleep disorder.

Abbreviations: ACE-I,angiotensin-converting-enzyme inhibitor; ARB angiotensin receptor blocker; β-blocker, beta-receptor antagonist; QTc, Corrected QT intervals; EF, ejection fraction; LVEDD, left ventricular end-diastolic internal diameter; NE, norepinephrine; E, adrenaline; DA, dopamine.

Table 5 The Coefficient Of Correlation Between The Plasma Level Of Catecholamine With PSQI

	PSQI	N	P value
NE (nmol/L)	0.422	80	<0.001
E (nmol/L)	0.388	80	<0.001
DA (nmol/L)	0.018	80	0.913

Notes: A rank correlation analysis was conducted for the relation between the plasma level of catecholamine with PSQI.

Abbreviations: NE, norepinephrine; E, adrenaline; DA dopamine; PSQI, Pittsburgh sleep quality index.