Prognosis of Patients With Heart Failure and Obstructive Sleep Apnea Treated With Continuous Positive Airway Pressure

Kasai, Takatoshi; Narui, Koji; Dohi, Tomotaka; Yanagisawa, Naotake; Ishiwata, Sugao; Ohno, Minoru; Yamaguchi, Tetsu; Momomura, Shin‐ichi

doi:10.1378/chest.07-1901

Cited by 208 publications

(117 citation statements)

References 19 publications

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“…29 Our data support prior fi ndings of Kasai et al, which showed heart failure patients with untreated or inadequately treated SDB are more likely to die or be hospitalized than patients who were compliant (average PAP use of 6 h/night). 32 In a larger scale study using Medicare claims, Javaheri et al found that patients with newly diagnosed heart failure and SDB who were started on PAP treatment had a better 2-year survival rate that those who were not treated. 33 However, this study was not able to document the effect of PAP compliance on survival or hospital readmission.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and Treatment of Sleep Disordered Breathing in Hospitalized Cardiac Patients: A Reduction in 30-Day Hospital Readmission Rates

Kauta

Keenan

Goldberg

et al. 2014

Journal of Clinical Sleep Medicine

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BRIEF SUMMARYCurrent Knowledge/Study Rationale: Sleep disordered breathing (SDB) is known to be common in patients with underlying cardiovascular disease. We hypothesized that diagnosing and initiating treatment for SDB in hospitalized cardiac patients would improve the overall management of their underlying cardiac condition. Study Impact: Our study identifi es a model of care that can increase the diagnosis and treatment of SDB in hospitalized cardiac patients. Finding a reduced 30-day cardiac readmission rate in CPAP adherent patients is important for both improving patient care and hospital fi nances.

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Section: Discussionmentioning

confidence: 99%

Diagnosis and Treatment of Sleep Disordered Breathing in Hospitalized Cardiac Patients: A Reduction in 30-Day Hospital Readmission Rates

Kauta

Keenan

Goldberg

et al. 2014

Journal of Clinical Sleep Medicine

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“…They can initiate additional PAP treatment because CPAP has previously demonstrated a decrease in mortality in this population of CHF patients with OSA 32. However, as underlined recently by Bradley et al .,33 there is currently no published randomized double‐blind study demonstrating the benefit of CPAP vs. sham CPAP in these patients with HFrEF.…”

Section: Pathophysiology Of Sleep‐disordered Breathing and Medical Trmentioning

confidence: 99%

“…The literature at that time indicated that the absence of specific treatment for SDBs could be associated with an increased morbimortality, in particular in patients with OSA. Indeed, for patients with a potential indication of additional PAP treatment, a longer duration of the study could be considered as a loss of chance 32. A 3‐month study appeared to be a good compromise and was recommended by the ethics committee.…”

Section: Pathophysiology Of Sleep‐disordered Breathing and Medical Trmentioning

confidence: 99%

Impact of sacubitril–valsartan combination in patients with chronic heart failure and sleep apnoea syndrome: the ENTRESTO‐SAS study design

et al. 2018

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AimsSleep‐disordered breathing (SDB) is a highly prevalent co‐morbidity in patients with chronic heart failure (CHF) and can play a detrimental role in the pathophysiology course of CHF. However, the best way to manage SDB in CHF remains a matter of debate. Sacubitril–valsartan has been included in the 2016 European Society of Cardiology guidelines as an alternative to angiotensin‐converting enzyme inhibitors to further reduce the risk of progression of CHF, CHF hospitalization, and death in ambulatory patients. Sacubitril and valsartan are good candidates for correcting SDB of CHF patients because their known mechanisms of action are likely to counteract the pathophysiology of SDB in CHF.Methods and resultsThe ENTRESTO‐SAS trial is a 3‐month, multicentric, prospective, open‐label real‐life cohort study. Patients eligible for sacubitril–valsartan treatment (i.e. adults with left ventricular ejection fraction ≤35%, who remain symptomatic despite optimal treatment with an angiotensin‐converting enzyme inhibitor, a beta‐blocker, and a mineralocorticoid receptor antagonist) will be evaluated before and after 3 months of treatment (nocturnal ventilatory polygraphy, echocardiography, laboratory testing, and quality‐of‐life and SDB questionnaires). The primary outcome is the change in the Apnoea–Hypopnoea Index, before and after 3 months of treatment. One hundred twenty patients are required to detect a significant 20% improvement of the Apnoea–Hypopnoea Index with a power of 90% at an alpha risk of 5%.ConclusionsIn the context of the SERVE‐HF study, physicians are waiting for new trials and alternative therapies. We sought to assess in the ENTRESTO‐SAS trial whether sacubitril–valsartan could improve the outcome of SDB in CHF patients.

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“…[129][130][131] In long-term studies, CPAP decreased mortality and improved hospitalization-free survival in patients with HF and OSA. 132,133 However, there are no double-blind randomized, controlled trials to evaluate these effects, particularly in the rehabilitation setting.…”

Section: Early Treatment Of Obstructive Sleep Apnea In Cardiovascularmentioning

confidence: 99%

Rehabilitation of Cardiovascular Disorders and Sleep Apnea

Jafari

2017

Sleep Medicine Clinics

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Prognosis of Patients With Heart Failure and Obstructive Sleep Apnea Treated With Continuous Positive Airway Pressure

Cited by 208 publications

References 19 publications

Diagnosis and Treatment of Sleep Disordered Breathing in Hospitalized Cardiac Patients: A Reduction in 30-Day Hospital Readmission Rates

Diagnosis and Treatment of Sleep Disordered Breathing in Hospitalized Cardiac Patients: A Reduction in 30-Day Hospital Readmission Rates

Impact of sacubitril–valsartan combination in patients with chronic heart failure and sleep apnoea syndrome: the ENTRESTO‐SAS study design

Rehabilitation of Cardiovascular Disorders and Sleep Apnea

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