Sleep Apnea in 81 Ambulatory Male Patients With Stable Heart Failure

Javaheri, Shahrokh; Parker, T. Jeffery; Liming, Jeanne; Corbett, William S.; Nishiyama, Hiroshi; Wexler, Laura; Roselle, Gary A.

doi:10.1161/01.cir.97.21.2154

Cited by 1,008 publications

(346 citation statements)

References 20 publications

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“…In terms of OSA in HFrEF patients, our rate of 29% is higher than values reported previously, which range from 11% to 26% 16, 19, 20. Conversely, our CSA prevalence rate of 31% was somewhat lower than in some studies (37% to 40%)19, 20 but higher than in another (26%) 16.…”

Section: Discussioncontrasting

confidence: 89%

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Phenotyping of Sleep‐Disordered Breathing in Patients With Chronic Heart Failure With Reduced Ejection Fraction—the SchlaHF Registry

Arzt

Oldenburg

Graml

et al. 2017

JAHA

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BackgroundDifferent sleep‐disordered breathing (SDB) phenotypes, including coexisting obstructive and central sleep apnea (OSA‐CSA), have not yet been characterized in a large sample of patients with heart failure and reduced ejection fraction (HFrEF) receiving guideline‐based therapies. Therefore, the aim of the present study was to determine the proportion of OSA, CSA, and OSA‐CSA, as well as periodic breathing, in HFrEF patients with SDB.Methods and ResultsThe German SchlaHF registry enrolled patients with HFrEF receiving guideline‐based therapies, who underwent portable SDB monitoring. Polysomnography (n=2365) was performed in patients with suspected SDB. Type of SDB (OSA, CSA, or OSA‐CSA), the occurrence of periodic breathing (proportion of Cheyne‐Stokes respiration ≥20%), and blood gases were determined in 1557 HFrEF patients with confirmed SDB. OSA, OSA‐CSA, and CSA were found in 29%, 40%, and 31% of patients, respectively; 41% showed periodic breathing. Characteristics differed significantly among SDB groups and in those with versus without periodic breathing. There was a relationship between greater proportions of CSA and the presence of periodic breathing. Risk factors for having CSA rather than OSA were male sex, older age, presence of atrial fibrillation, lower ejection fraction, and lower awake carbon dioxide pressure (pco 2). Periodic breathing was more likely in men, patients with atrial fibrillation, older patients, and as left ventricular ejection fraction and awake pco 2 decreased, and less likely as body mass index increased and minimum oxygen saturation decreased.ConclusionsSchlaHF data show that there is wide interindividual variability in the SDB phenotype of HFrEF patients, suggesting that individualized management is appropriate.Clinical Trial Registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT01500759.

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Section: Discussioncontrasting

confidence: 89%

“…Only a few studies to date have characterized different phenotypes for patients with HF and SDB 16, 19, 20, 21. Tkacova et al reported coexisting OSA and CSA in 12 of 65 patients with HFrEF 22.…”

Section: Introductionmentioning

confidence: 99%

Phenotyping of Sleep‐Disordered Breathing in Patients With Chronic Heart Failure With Reduced Ejection Fraction—the SchlaHF Registry

Arzt

Oldenburg

Graml

et al. 2017

JAHA

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“…The prevalence of SDB (AHI ≥ 15/h) was 44%, which is comparable to that reported in previous studies 1, 2, 3, 4. SM/PSG signals from 80 patients were successfully collected.…”

Section: Discussionsupporting

confidence: 83%

“…Sleep‐disordered breathing (SDB) is prevalent in patients with chronic heart failure (CHF), typically occurring in ≥50% of patients 1, 2, 3, 4. SDB is characterized by periods of apnoea (cessation or >90% reduction in ventilation) and hypopnoea (>30% reduction in ventilation associated with oxygen desaturation of ≥4%) 5.…”

Section: Introductionmentioning

confidence: 99%

“…SDB is characterized by periods of apnoea (cessation or >90% reduction in ventilation) and hypopnoea (>30% reduction in ventilation associated with oxygen desaturation of ≥4%) 5. Importantly, SDB is associated with increased cardiovascular morbidity and mortality, an association that persists after adjustment for other clinical predictors of outcome 1, 6, 7, 8.…”

Section: Introductionmentioning

confidence: 99%

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Development and validation of a novel non‐contact monitor of nocturnal respiration for identifying sleep‐disordered breathing in patients with heart failure

et al. 2016

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AimsAt least 50% of patients with heart failure (HF) may have sleep‐disordered breathing (SDB). Overnight in‐hospital polysomnography (PSG) is considered the gold standard for diagnosis, but a lack of access to such testing contributes to under‐diagnosis of SDB. Therefore, there is a need for simple and reliable validated methods to aid diagnosis in patients with HF. The aim of this study was to investigate the accuracy of a non‐contact type IV screening device, SleepMinderTM (SM), compared with in‐hospital PSG for detecting SDB in patients with HF.Methods and resultsThe study included 75 adult patients with systolic HF and suspected SDB who underwent simultaneous PSG and SM recordings. An algorithm was developed from the SM signals, using digital signal processing and pattern recognition techniques to calculate the SM apnoea‐hypopnoea index (AHI). This was then compared with expert‐scored PSGAHI. The SM algorithm had 70% sensitivity and 89% specificity for identifying patients with clinically significant SDB (AHI ≥ 15/h). At this threshold, it had a positive likelihood ratio of 6.3 and a negative likelihood ratio of 0.16. The overall accuracy of the SMAHI algorithm was 85.8% as shown by the area under a receiver operator characteristic curve. The mean AHI with SM was 3.8/h (95% confidence interval 0.5–7.1) lower than that with PSG.ConclusionsThe accuracy of the non‐contact type IV screening device SM is good for clinically significant SDB in patients with systolic HF and could be considered as a simple first step in the diagnostic pathway.

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Bilateral Leg Edema, Obesity, Pulmonary Hypertension, and Obstructive Sleep Apnea

Blankfield¹,

Hudgel²,

Tapolyai³

et al. 2000

Arch Intern Med

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Background: Pulmonary hypertension is usually due to an underlying cardiac or pulmonary condition. An association between unexplained pulmonary hypertension and bilateral leg edema in primary care patients was found previously. We undertook this study to identify the frequency of obstructive sleep apnea (OSA) in ambulatory, adult patients with pulmonary hypertension who initially presented with bilateral leg edema.

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Sleep Apnea in 81 Ambulatory Male Patients With Stable Heart Failure

Cited by 1,008 publications

References 20 publications

Phenotyping of Sleep‐Disordered Breathing in Patients With Chronic Heart Failure With Reduced Ejection Fraction—the SchlaHF Registry

Phenotyping of Sleep‐Disordered Breathing in Patients With Chronic Heart Failure With Reduced Ejection Fraction—the SchlaHF Registry

Development and validation of a novel non‐contact monitor of nocturnal respiration for identifying sleep‐disordered breathing in patients with heart failure

Bilateral Leg Edema, Obesity, Pulmonary Hypertension, and Obstructive Sleep Apnea

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