Paulus, Michael G. and Liedtke, Tobias and Hamerle, Michael and Schach, Christian and Maier, Lars S. and Stadler, Stefan and Birner, Christoph and Debl, Kurt and Arzt, Michael and Unsoeld, Bernhard and Meindl, Christine (2023) Impact of transcatheter edge-to-edge mitral valve repair on central sleep apnoea. CLINICAL RESEARCH IN CARDIOLOGY, 112 (5). pp. 594-604. ISSN 1861-0684, 1861-0692
Full text not available from this repository. (Request a copy)Abstract
Aims Sleep-disordered breathing (SDB) and its subtype central sleep apnoea (CSA) are highly prevalent in patients with heart failure and associated with worse prognosis. Whereas pharmacological therapy of heart failure has been shown to ameliorate CSA, results from previous studies on the effect of mitral regurgitation therapy on SDB are contradicting. The aim of this study was to assess the impact of transcatheter edge-to-edge mitral valve repair (TEER) on prevalence and severity of CSA. Methods and results We enrolled 47 patients undergoing TEER for symptomatic mitral regurgitation in a prospective study. Secondary mitral regurgitation and left ventricular ejection fraction < 50% were present in 79% and 68% of patients, respectively. Respiratory polygraphy was performed before TEER in a compensated condition and four weeks after the procedure. 34 patients completed the follow-up. At baseline, 19 (56%) patients showed moderate-to-severe SDB, of whom 13 (68%) were classified as CSA. Both apnoea-hypopnoea index and percentage of recorded time spent in Cheyne-Stokes respiration strongly decreased from baseline to follow-up (median [IQR] 16 [7-30] vs. 7 [4-15] /h, p = 0.007; 6 [0-34] vs. 0 [0-8] %, p = 0.008). Median relative reduction of central apnoea index was 75% (p = 0.023), while obstructive apnoea index did not change significantly. Increase in stroke volume after TEER and high systolic pulmonary artery pressure at baseline predicted a > 50% reduction of both Apnoea-hypopnoea index and Cheyne-Stokes respiration. Conclusion TEER is associated with a significant short-term reduction of CSA and Cheyne-Stokes respiration in high-risk patients, strengthening its value as an effective treatment option for advanced heart failure.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CHEYNE-STOKES RESPIRATION; CHRONIC HEART-FAILURE; TRICUSPID REGURGITATION; DEVICE; APNEALINK(TM); PATHOGENESIS; PREVALENCE; VALIDATION; PREDICTORS; Sleep apnoea; Sleep-disordered breathing; Cheyne-Stokes respiration; Mitral regurgitation; Transcatheter mitral valve repair; Edge-to-edge mitral valve repair |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 05 Mar 2024 09:37 |
| Last Modified: | 05 Mar 2024 09:37 |
| URI: | https://pred.uni-regensburg.de/id/eprint/57306 |
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