BACKGROUND-: Sleep and exertional periodic breathing are proverbial in chronic heart failure (CHF), and each alone indicates poor prognosis. Whether these conditions are associated and whether excess risk may be attributed to respiratory disorders in general, rather than specifically during sleep or exercise, is unknown. METHODS AND RESULTS-: We studied 133 CHF patients with left ventricular ejection fraction (LVEF) ≤40%. During 1170±631 days of follow-up, 31 patients (23%) died. Nonsurvivors had higher New York Heart Association class, ventilatory response (&OV0312;e/&OV0312;co2 slope), and apnea-hypopnea index (AHI) and lower peak &OV0312;o2 (all P30/h. EOV was significantly related to AHI >30/h (χ 14.6, P30/h. Multivariable analysis, including breathing disorders alone (EOV, AHI >30/h) or in combination (EOV plus AHI >30/h), selected combined disorders as the strongest predictor of events (HR 6.65, 95% CI 2.6 to 17.1, P30/h. Although each breathing disorder alone is linked to total mortality, their combination has a crucial prognostic burden.
- Heart failure
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine