Jilek, Clemens and Krenn, Marion and Sebah, Daniela and Obermeier, Ruth and Braune, Astrid and Kehl, Victoria and Schroll, Stephan and Montalvan, Sylvia and Riegger, Guenter A. J. and Pfeifer, Michael and Arzt, Michael (2011) Prognostic impact of sleep disordered breathing and its treatment in heart failure: an observational study. EUROPEAN JOURNAL OF HEART FAILURE, 13 (1). pp. 68-75. ISSN 1388-9842, 1879-0844
Full text not available from this repository. (Request a copy)Abstract
Aims Sleep disordered breathing (SDB) may contribute to disease progression in patients with chronic heart failure (CHF). The objective of this observational study was to evaluate whether SDB is a risk factor for mortality in CHF patients and whether this risk can be attenuated by treatment with positive airway pressure (PAP). Methods and results We studied 296 CHF patients (median left ventricular ejection fraction 33%) who underwent in-lab polysomnography between January 2002 and December 2009. We compared (i) mortality between patients with severe SDB [apnoeahypopnoea index (AHI) >= 22.5 h(21)] vs. those without severe SDB (AHI < 22.5 h(21)) and (ii) evaluated the impact of PAP treatment on mortality in those with severe SDB. After accounting for significant confounding factors (age, NYHA class, cause of CHF, diabetes, and PAP treatment), patients with severe SDB (n = 176) had a 2.0-fold increased hazard ratio for death compared with those without severe SDB [95% confidence interval (CI) 1.1-3.5, P = 0.023]. In an adjusted on-treatment analysis of the group with severe SDB, mortality was significantly less in patients using PAP (18%) compared with those with untreated SDB (52%; hazard ratio 0.4, 95% CI 0.2-0.6, P = 0.001). Mortality in the PAP-treated group was lower compared with the untreated group at any time-point of the follow-up period. Conclusion The presence of severe SDB in CHF patients constitutes a significantly increased risk for death, independent of established risk factors. In CHF patients with SDB, use of PAP therapy was associated with a decreased mortality rate at any time point of the follow-up, suggesting that PAP can be safely used in such patients.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | POSITIVE AIRWAY PRESSURE; CHEYNE-STOKES RESPIRATION; SYMPATHETIC-NERVE ACTIVITY; APNEA; MORTALITY; TRIAL; OUTCOMES; CARE; Survival; Prognosis; Sleep apnoea; Positive airway pressure; Heart failure |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 29 Jun 2020 12:08 |
| Last Modified: | 29 Jun 2020 12:08 |
| URI: | https://pred.uni-regensburg.de/id/eprint/21573 |
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