Clinical relevance of short-term day-time breathing disorders in chronic heart failure patients

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Periodic Breathing (PB, waxing and waning of tidal volume in which hyperventilation alternates with periods of apnoea or hypopnoea), is common during sleep and wakefulness in patients with Heart Failure (HF) and may increase mortality. Aim: To assess the effect of short-term, day-time PB on prognosis, in HF patients. Methods: We prospectively studied 380 consecutive HF referrals who had a 10 min, supine day-time respiratory recording. We related PB (adjusted for known predictors) to total cardiac mortality, during a median follow-up of 41 months. Results: Day-time PB occurred in 145/380 patients who had more severe HF and more compromised left ventricular function (p <0.005). Survival curves began to separate after 10 months and diverged steadily over the next 4 years with a cumulative risk of 41% (PB) vs 26% (No-PB), p = 0.002. PB was independently predictive of increased cardiac mortality when entered into a clinical prognostic model (including NYHA Class, LVEF, LVEDD, Systolic Arterial Pressure, beta-blocker treatment, peak VO2 and blood urea) with a RR: 1.8, 95% CI 1.20-2.81. Conclusion: In advanced HF the presence of PB during a short day-time recording adds to known predictors of cardiac mortality. This may have practical implications for trials of HF therapy.

Original languageEnglish
Pages (from-to)949-954
Number of pages6
JournalEuropean Journal of Heart Failure
Volume9
Issue number9
DOIs
Publication statusPublished - Sep 2007

Keywords

  • Heart failure
  • Mortality
  • Prognosis
  • Respiration
  • Sleep

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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