© 2007 European Society of Cardiology
Influence of cardiac resynchronisation therapy on different types of sleep disordered breathing
a Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum Georgstrasse 11, D-32545 Bad Oeynhausen, Germany
b Institute of Laboratory and Transfusion Medicine, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum Georgstrasse 11, D-32545 Bad Oeynhausen, Germany
* Corresponding author. Tel.: +49 5731 97 1258; fax: +49 5731 97 2194 E-mail address: akohlstaedt{at}hdz-nrw.de.
 |
Abstract |
|---|
Aims: This study investigates the influence of cardiac resynchronisation therapy (CRT) on sleep disordered breathing (SDB) in patients with severe heart failure (HF).
Methods and results: Seventy-seven patients with HF (19 females; 62.6±10 years) eligible for CRT were screened for presence, type, and severity of SDB before and after CRT initiation (5.3±3 months) using cardiorespiratory polygraphy. NYHA class, frequency of nycturia, cardiopulmonary exercise, 6-minute walking test results, and echocardiography parameters were obtained at baseline and follow-up.
Central sleep apnoea (CSA) was documented in 36 (47%), obstructive sleep apnoea (OSA) in 26 (34%), and no SDB in 15 (19%) patients. CRT improved clinical and haemodynamic parameters. SDB parameters improved in CSA patients only (apnoea hypopnoea index: 31.2±15.5 to 17.3±13.7/h, p<0.001; SaO2min: 81.8±6.6 to 84.8±3.3%, p=0.02, desaturation: 6.5±2.3 to 5.5±0.8%, p=0.004). Daytime capillary pCO2 was significantly lower in CSA patients compared to those without SDB with a trend towards increase with CRT (35.5±4.2 to 37.9±5.7 mm Hg, ns). After classifying short term clinical and haemodynamic CRT effects, improved SDB parameters in CSA occurred in responders only.
Conclusions: In patients with severe HF eligible for CRT, CSA is common and can be influenced by CRT, this improvement depends on good clinical and haemodynamic response to CRT.
Key Words: Heart failure • Cardiac resynchronisation therapy • Sleep disordered breathing • Central sleep apnoea
Received August 10, 2006; Revised February 16, 2007; Accepted March 22, 2007
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  R. Baruah, C. H. Manisty, A. Giannoni, K. Willson, Y. Mebrate, A. J. Baksi, B. Unsworth, N. Hadjiloizou, R. Sutton, J. Mayet, et al. Novel Use of Cardiac Pacemakers in Heart Failure to Dynamically Manipulate the Respiratory System Through Algorithmic Changes in Cardiac Output Circ Heart Fail, May 1, 2009; 2(3): 166 - 174. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Luthje, B. Renner, R. Kessels, D. Vollmann, T. Raupach, B. Gerritse, S. Tasci, J. O. Schwab, M. Zabel, D. Zenker, et al. Cardiac resynchronization therapy and atrial overdrive pacing for the treatment of central sleep apnoea Eur J Heart Fail, March 1, 2009; 11(3): 273 - 280. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. N. Simantirakis, S. E. Schiza, N. S. Siafakas, and P. E. Vardas Sleep-disordered breathing in heart failure and the effect of cardiac resynchronization therapy Europace, September 1, 2008; 10(9): 1029 - 1033. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Oldenburg, A. Schmidt, B. Lamp, T. Bitter, B. G. Muntean, C. Langer, and D. Horstkotte Adaptive servoventilation improves cardiac function in patients with chronic heart failure and Cheyne-Stokes respiration Eur J Heart Fail, June 1, 2008; 10(6): 581 - 586. [Abstract] [Full Text] [PDF]
|
|