Universität zu Köln

Arzt, Michael, Oldenburg, Olaf, Graml, Andrea, Stat, Dipl, Erdmann, Erland, Teschler, Helmut, Wegscheider, Karl, Suling, Anna and Woehrle, Holger (2017). Phenotyping of Sleep-Disordered Breathing in Patients With Chronic Heart Failure With Reduced Ejection Fraction-the SchlaHF Registry. J. Am. Heart Assoc., 6 (12). HOBOKEN: WILEY. ISSN 2047-9980

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Abstract

Background-Different 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 Results-The 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 (PCO2). Periodic breathing was more likely in men, patients with atrial fibrillation, older patients, and as left ventricular ejection fraction and awake PCO2 decreased, and less likely as body mass index increased and minimum oxygen saturation decreased. Conclusions-SchlaHF data show that there is wide interindividual variability in the SDB phenotype of HFrEF patients, suggesting that individualized management is appropriate.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Arzt, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Oldenburg, Olaf UNSPECIFIED UNSPECIFIED UNSPECIFIED Graml, Andrea UNSPECIFIED UNSPECIFIED UNSPECIFIED Stat, Dipl UNSPECIFIED UNSPECIFIED UNSPECIFIED Erdmann, Erland UNSPECIFIED UNSPECIFIED UNSPECIFIED Teschler, Helmut UNSPECIFIED UNSPECIFIED UNSPECIFIED Wegscheider, Karl UNSPECIFIED UNSPECIFIED UNSPECIFIED Suling, Anna UNSPECIFIED UNSPECIFIED UNSPECIFIED Woehrle, Holger UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-208668
DOI:	10.1161/JAHA.116.005899
Journal or Publication Title:	J. Am. Heart Assoc.
Volume:	6
Number:	12
Date:	2017
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	2047-9980
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CHEYNE-STOKES RESPIRATION; APNEA; EPIDEMIOLOGY; PREVALENCE; PREDICTORS; MORTALITY; UPDATE; ASSOCIATION; DYSFUNCTION; GUIDELINES Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/20866