title: Sleep-disordered breathing in heart failure with normal left ventricular ejection fraction.
abstract: OBJECTIVE
  In patients with systolic heart failure (SHF) a high prevalence of sleep-disordered breathing (SDB) has been documented. The purpose of this study was to investigate the prevalence and type of SDB in patients with heart failure with normal left ventricular ejection fraction (HFNEF).
  
  
  RESULTS
  Two hundred and forty-four consecutive patients (87 women, aged 65.3 +/- 1.4 years) with HFNEF underwent capillary blood gas analysis, measurement of NT-proBNP concentrations, echocardiography, cardiopulmonary exercise testing (CPX), cardiorespiratory polygraphy, and simultaneous right and left heart catheterization. Sleep-disordered breathing was defined as an apnoea-hypopnoea-index (AHI) > or = 5/h. Sleep-disordered breathing was documented in 69.3% of all patients, 97 patients (39.8%) presented with OSA and 72 patients (29.5%) with CSA. With an increasing impairment of diastolic function the proportion of SDB, and CSA in particular, increased. Patients with SDB performed worse on CPX and six-minute walk test. Partial pressure of CO(2) was lower in CSA, whereas AHI, left atrial diameter, NT-proBNP, LVEDP, PAP, and PCWP were higher.
  
  
  CONCLUSIONS
  There is a high prevalence of SDB in HFNEF. In parallel to SHF, CSA patients in particular are characterized by a more impaired cardiopulmonary function. Whether SDB is of prognostic relevance in HFNEF needs to be determined.
authors.affiliation: Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Georgstasse 11, D-32545 Bad Oeynhausen, Germany. akohlstaedt@hdz-nrw.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Bitter
authors.forename: Lothar
authors.initials: L
authors.lastname: Faber
authors.forename: Detlef
authors.initials: D
authors.lastname: Hering
authors.forename: Christoph
authors.initials: C
authors.lastname: Langer
authors.forename: Dieter
authors.initials: D
authors.lastname: Horstkotte
authors.forename: Olaf
authors.initials: O
authors.lastname: Oldenburg
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization; D004452:Echocardiography; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006333:Heart Failure / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D008297:Male; D010991:Plethysmography; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012891:Sleep Apnea Syndromes / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D013318:Stroke Volume / Q000502:physiology*; D016277:Ventricular Function, Left / Q000502:physiology*