Advertisement





Click here for more guidelines.
CME Topic Collections Past Issues Search Current Issue Home
     

J Am Coll Cardiol, 2007; 49:2028-2034, doi:10.1016/j.jacc.2007.01.084 (Published online 3 May 2007).
© 2007 by the American College of Cardiology Foundation
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
j.jacc.2007.01.084v1
49/20/2028    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via ISI Web of Science (27)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Javaheri, S.
Right arrow Articles by Wexler, L.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Javaheri, S.
Right arrow Articles by Wexler, L.

CLINICAL RESEARCH: HEART FAILURE

Central Sleep Apnea, Right Ventricular Dysfunction, and Low Diastolic Blood Pressure Are Predictors of Mortality in Systolic Heart Failure

Shahrokh Javaheri, MD*, Rakesh Shukla, PhD, Haoyue Zeigler, MS and Laura Wexler, MD

Department of Veterans Affairs Medical Center, Cincinnati, Ohio; and the Departments of Medicine and Environmental Health, University of Cincinnati College of Medicine, Cincinnati, Ohio.

Manuscript received November 9, 2006; revised manuscript received January 19, 2007, accepted January 29, 2007.

* Reprint requests and correspondence: Dr. Shahrokh Javaheri, Pulmonary Section (111F), VA Medical Center, Cincinnati, Ohio 45220. (Email: Javaheri{at}snorenomore.com).

Objectives: The purpose of this study was to determine whether central sleep apnea (CSA) contributes to mortality in patients with heart failure (HF).

Background: Cheyne-Stokes breathing with CSA commonly occurs in patients with systolic HF. Consequences of CSA, including altered blood gases and neurohormonal activation, could result in further left ventricular dysfunction. Therefore, we hypothesized that CSA might contribute to mortality of patients with HF.

Methods: We followed 88 patients with systolic HF (left ventricular ejection fraction ≤45%) with (n = 56) or without (n = 32) CSA. The median follow-up was 51 months.

Results: The mean (±SD) of apnea-hypopnea index was significantly higher in patients with CSA (34 ± 25/h) than those without CSA (2 ± 1/h). Most of these events were central apneas. In Cox multiple regression analysis, 3 of 24 confounding variables independently correlated with survival. The median survival of patients with CSA was 45 months compared with 90 months of those without CSA (hazard ratio = 2.14, p = 0.02). The other 2 variables that correlated with poor survival were severity of right ventricular systolic dysfunction and low diastolic blood pressure.

Conclusions: In patients with systolic HF, CSA, severe right ventricular systolic dysfunction, and low diastolic blood pressure might have an adverse effect on survival.

Abbreviations and Acronyms
  AHI = apnea-hypopnea index
  CPAP = continuous positive airway pressure
  CSA = central sleep apnea
  CSB = Cheyne-Stokes breathing
  HF = heart failure
  LVEF = left ventricular ejection fraction
  RVEF = right ventricular ejection fraction




This article has been cited by other articles:


Home page
HeartHome page
J S Floras
Should sleep apnoea be a specific target of therapy in chronic heart failure?
Heart, July 1, 2009; 95(13): 1041 - 1046.
[Abstract] [Full Text] [PDF]


Home page
Eur J Heart FailHome page
T. Bitter, L. Faber, D. Hering, C. Langer, D. Horstkotte, and O. Oldenburg
Sleep-disordered breathing in heart failure with normal left ventricular ejection fraction
Eur J Heart Fail, June 1, 2009; 11(6): 602 - 608.
[Abstract] [Full Text] [PDF]


Home page
HeartHome page
D Yumino, H Wang, J S Floras, G E Newton, S Mak, P Ruttanaumpawan, J D Parker, and T D Bradley
Relationship between sleep apnoea and mortality in patients with ischaemic heart failure
Heart, May 1, 2009; 95(10): 819 - 824.
[Abstract] [Full Text] [PDF]


Home page
Eur J Heart FailHome page
G. D. Pinna, R. Maestri, A. Mortara, P. Johnson, D. Andrews, P. Ponikowski, T. Witkowski, E. Robbi, M. T. La Rovere, and P. Sleight
Pathophysiological and clinical relevance of simplified monitoring of nocturnal breathing disorders in heart failure patients
Eur J Heart Fail, March 1, 2009; 11(3): 264 - 272.
[Abstract] [Full Text] [PDF]


Home page
Eur J Heart FailHome page
A. Mortara, G. D. Pinna, P. Johnson, R. Maestri, S. Capomolla, M. T. La Rovere, P. Ponikowski, L. Tavazzi, P. Sleight, and on behalf of the HHH Investigators
Home telemonitoring in heart failure patients: the HHH study (Home or Hospital in Heart Failure)
Eur J Heart Fail, March 1, 2009; 11(3): 312 - 318.
[Abstract] [Full Text] [PDF]


Home page
Eur Respir JHome page
P. Levy, J-L. Pepin, C. Arnaud, R. Tamisier, J-C. Borel, M. Dematteis, D. Godin-Ribuot, and C. Ribuot
Intermittent hypoxia and sleep-disordered breathing: current concepts and perspectives
Eur. Respir. J., October 1, 2008; 32(4): 1082 - 1095.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
V. K. Somers, D. P. White, R. Amin, W. T. Abraham, F. Costa, A. Culebras, S. Daniels, J. S. Floras, C. E. Hunt, L. J. Olson, et al.
Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement From the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health)
Circulation, September 2, 2008; 118(10): 1080 - 1111.
[Full Text] [PDF]


Home page
J Am Coll CardiolHome page
V. K. Somers, D. P. White, R. Amin, W. T. Abraham, F. Costa, A. Culebras, S. Daniels, J. S. Floras, C. E. Hunt, L. J. Olson, et al.
Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement From the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health)
J. Am. Coll. Cardiol., August 19, 2008; 52(8): 686 - 717.
[Full Text] [PDF]


Home page
ChestHome page
L. K. Brown
Filling in the Gaps: The Role of Noninvasive Adaptive Servoventilation for Heart Failure-Related Central Sleep Apnea
Chest, July 1, 2008; 134(1): 4 - 7.
[Full Text] [PDF]


Home page
ChestHome page
M. Arzt, R. Wensel, S. Montalvan, T. Schichtl, S. Schroll, S. Budweiser, F. C. Blumberg, G. A. J. Riegger, and M. Pfeifer
Effects of Dynamic Bilevel Positive Airway Pressure Support on Central Sleep Apnea in Men With Heart Failure
Chest, July 1, 2008; 134(1): 61 - 66.
[Abstract] [Full Text] [PDF]


Home page
ChestHome page
A. Garcia-Touchard, V. K. Somers, L. J. Olson, and S. M. Caples
Central Sleep Apnea: Implications for Congestive Heart Failure
Chest, June 1, 2008; 133(6): 1495 - 1504.
[Abstract] [Full Text] [PDF]


Home page
Proc Am Thorac SocHome page
D. Yumino and T. D. Bradley
Central Sleep Apnea and Cheyne-Stokes Respiration
Proceedings of the ATS, February 15, 2008; 5(2): 226 - 236.
[Abstract] [Full Text] [PDF]


Home page
Eur Respir JHome page
O. Oldenburg, B. Lamp, G. Freudenberg, and D. Horstkotte
Screening for sleep-disordered breathing is recommended in patients with chronic heart failure
Eur. Respir. J., November 1, 2007; 30(5): 1023 - 1023.
[Full Text] [PDF]


Home page
Eur Respir JHome page
K. A. Franklin
From the author
Eur. Respir. J., November 1, 2007; 30(5): 1023 - 1024.
[Full Text] [PDF]



 
  CME Topic Collections Past Issues Search Current Issue Home

Advertisement