Phenotyping of Sleep‐Disordered Breathing in Patients With Chronic Heart Failure With Reduced Ejection Fraction—the SchlaHF Registry

Medientyp: E-Artikel
Titel: Phenotyping of Sleep‐Disordered Breathing in Patients With Chronic Heart Failure With Reduced Ejection Fraction—the SchlaHF Registry
Beteiligte: Arzt, Michael; Oldenburg, Olaf; Graml, Andrea; Erdmann, Erland; Teschler, Helmut; Wegscheider, Karl; Suling, Anna; Woehrle, Holger
Erschienen: Ovid Technologies (Wolters Kluwer Health), 2017
Erschienen in: Journal of the American Heart Association
Sprache: Englisch
DOI: 10.1161/jaha.116.005899
ISSN: 2047-9980
Entstehung:
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Beschreibung: <jats:sec xml:lang="en"> <jats:title>Background</jats:title> <jats:p xml:lang="en"> Different sleep‐disordered breathing ( <jats:styled-content style="fixed-case">SDB</jats:styled-content> ) phenotypes, including coexisting obstructive and central sleep apnea ( <jats:styled-content style="fixed-case">OSA</jats:styled-content> ‐ <jats:styled-content style="fixed-case">CSA</jats:styled-content> ), have not yet been characterized in a large sample of patients with heart failure and reduced ejection fraction ( <jats:styled-content style="fixed-case">HF</jats:styled-content> r <jats:styled-content style="fixed-case">EF</jats:styled-content> ) receiving guideline‐based therapies. Therefore, the aim of the present study was to determine the proportion of <jats:styled-content style="fixed-case">OSA</jats:styled-content> , <jats:styled-content style="fixed-case">CSA</jats:styled-content> , and <jats:styled-content style="fixed-case">OSA</jats:styled-content> ‐ <jats:styled-content style="fixed-case">CSA</jats:styled-content> , as well as periodic breathing, in <jats:styled-content style="fixed-case">HF</jats:styled-content> r <jats:styled-content style="fixed-case">EF</jats:styled-content> patients with <jats:styled-content style="fixed-case">SDB</jats:styled-content> . </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Methods and Results</jats:title> <jats:p xml:lang="en"> The German Schla <jats:styled-content style="fixed-case">HF</jats:styled-content> registry enrolled patients with <jats:styled-content style="fixed-case">HF</jats:styled-content> r <jats:styled-content style="fixed-case">EF</jats:styled-content> receiving guideline‐based therapies, who underwent portable <jats:styled-content style="fixed-case">SDB</jats:styled-content> monitoring. Polysomnography (n=2365) was performed in patients with suspected <jats:styled-content style="fixed-case">SDB</jats:styled-content> . Type of <jats:styled-content style="fixed-case">SDB</jats:styled-content> ( <jats:styled-content style="fixed-case">OSA</jats:styled-content> , <jats:styled-content style="fixed-case">CSA</jats:styled-content> , or <jats:styled-content style="fixed-case">OSA</jats:styled-content> ‐ <jats:styled-content style="fixed-case">CSA</jats:styled-content> ), the occurrence of periodic breathing (proportion of Cheyne‐Stokes respiration ≥20%), and blood gases were determined in 1557 <jats:styled-content style="fixed-case">HF</jats:styled-content> r <jats:styled-content style="fixed-case">EF</jats:styled-content> patients with confirmed <jats:styled-content style="fixed-case">SDB</jats:styled-content> . <jats:styled-content style="fixed-case">OSA</jats:styled-content> , <jats:styled-content style="fixed-case">OSA</jats:styled-content> ‐ <jats:styled-content style="fixed-case">CSA</jats:styled-content> , and <jats:styled-content style="fixed-case">CSA</jats:styled-content> were found in 29%, 40%, and 31% of patients, respectively; 41% showed periodic breathing. Characteristics differed significantly among <jats:styled-content style="fixed-case">SDB</jats:styled-content> groups and in those with versus without periodic breathing. There was a relationship between greater proportions of <jats:styled-content style="fixed-case">CSA</jats:styled-content> and the presence of periodic breathing. Risk factors for having <jats:styled-content style="fixed-case">CSA</jats:styled-content> rather than <jats:styled-content style="fixed-case">OSA</jats:styled-content> were male sex, older age, presence of atrial fibrillation, lower ejection fraction, and lower awake carbon dioxide pressure ( <jats:sc>pco</jats:sc> <jats:sub>2</jats:sub> ). Periodic breathing was more likely in men, patients with atrial fibrillation, older patients, and as left ventricular ejection fraction and awake <jats:sc>pco</jats:sc> <jats:sub>2</jats:sub> decreased, and less likely as body mass index increased and minimum oxygen saturation decreased. </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Conclusions</jats:title> <jats:p xml:lang="en"> Schla <jats:styled-content style="fixed-case">HF</jats:styled-content> data show that there is wide interindividual variability in the <jats:styled-content style="fixed-case">SDB</jats:styled-content> phenotype of <jats:styled-content style="fixed-case">HF</jats:styled-content> r <jats:styled-content style="fixed-case">EF</jats:styled-content> patients, suggesting that individualized management is appropriate. </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Clinical Trial Registration</jats:title> <jats:p xml:lang="en"> <jats:styled-content style="fixed-case">URL</jats:styled-content> : <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://www.clinicaltrials.gov/">https://www.clinicaltrials.gov/</jats:ext-link> . Unique identifier: <jats:styled-content style="fixed-case">NCT</jats:styled-content> 01500759. </jats:p> </jats:sec>
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