clinical investigations Prevalence ofSleep-Disordered Breathing inDiastolic HeartFailure*

2017 
Objective: Sleep-disordered breathing (SDB) iscommon incongestive heartfailure. While isolated diastolic heart failure (DHF) accountsforuptoa third ofall casesofcongestive heart failure, theprevalence ofSDB inDHF isunknown. We aimtodetermine theprevalence and characteristics ofSDBina groupofpatients withsymptomatic DHF. Methods: Twenty subjects withsymptomatic DHF (New YorkHeartAssociation class IIorIII) and isolated diastolic dysfunction on echocardiography were assessed withlung function tests, modified sleep andhealth questionnaire, andovernight polysomnography. Significant SDB was defined as an apnea/hypopnea index(AHI) >10. Results: Thirteen female andseven malesubjects (mean age, 65±6.0years; mean body mass index (BMI), 28±3.2) were evaluated, ofwhom17(85%) hadadiagnosis ofhypertension. Overall sleep quality was poor, withfragmentation andfrequent arousals associated withrespiratory events. Fifty-five percent ofthepatients hadsignificant SDB,mainly obstructive apneas. BMIandthe prevalence ofhypertension were similar inpatients withandwithout SDB.Thedeceleration time, an index ofdiastolic dysfunction, was more prolonged inthegroupwithSDB(236 ±40ms vs 282±31ms;p<0.05). Asa group, a lower minimumpercentage arterial oxygen saturation during sleep, butnottheAHIwas associated with more severedegree ofdiastolic dysfunction on echocardiogram, including alower ratio between theearly peak transmittal flowvelocity andthe latepeak atrial systolic velocity (rho=0.57; p<0.05) andaprolonged isovolumic relaxation time (rho=-0.54;p<0.05). Conclusions: SDB iscommon inpatients withDHF. Patients withDHF andSDB maybe associated with worse diastolic dysfunction thanthose without SDB,although a causal relation¬ ship remains tobeestablished. (CHEST 1997; 111:1488-93)
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