© 2007 European Society of Cardiology
Sleep-disordered breathing in patients with symptomatic heart failure A contemporary study of prevalence in and characteristics of 700 patients
a Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia Georgstrasse 11, D-32545 Bad Oeynhausen, Germany
b Department of Pneumology and Sleep Medicine Ruhrlandklinik, University Duisburg-Essen, Essen, Germany
* Corresponding author. Tel.: +49 5731 97 0; fax: +49 5731 97 2194. E-mail address: ooldenburg{at}hdz-nrw.de
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Abstract |
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Aim: Evaluation of the prevalence and nature of sleep-disordered breathing (SDB) in patients with symptomatic chronic heart failure (CHF) receiving therapy according to current guidelines.
Methods and results: We prospectively screened 700 patients with CHF (NYHA class
II, LV-EF
40%) for SDB using cardiorespiratory polygraphy (EmblettaTM). Furthermore, echocardiography, cardiopulmonary exercise and 6-min walk testing were performed. Medication included ACE-inhibitors and/or AT1-receptor blockers in at least 94%, diuretics in 87%, β-blockers in 85%, digitalis in 61% and spironolactone in 62% of patients.
SDB was present in 76% of patients (40% central (CSA), 36% obstructive sleep apnoea (OSA)). CSA patients were more symptomatic (NYHA class 2.9±0.5 vs. no SDB 2.57±0.5 or OSA 2.57±0.5; p<0.05) and had a lower LV-EF (27.4±6.6% vs. 29.3±2.6%, p<0.05) than OSA patients. Oxygen uptake (VO2) was lowest in CSA patients: predicted peak VO2 57±16% vs. 64±18% in OSA and 63±17% in no SDB, p<0.05. 6-min walking distances were 331±111m in CSA, 373±108m in OSA and 377±118m in no SDB (p<0.05).
Conclusions: This study confirms the high prevalence of SDB, particularly CSA in CHF patients. CSA seems to be a marker of heart failure severity.
Key Words: Congestive heart failure • Sleep-disordered breathing • Sleep apnoea syndromes
Received April 1, 2006; Revised June 28, 2006; Accepted August 22, 2006
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