Valve repair improves central sleep apnea in heart failure patients with valvular heart diseases.
BACKGROUND
Recent studies suggest that treatment of heart failure (HF) could improve cardiac function and sleep apnea syndrome (SAS), but it is unknown how cardiac surgery may affect SAS in HF patients. Relationships between HF with valvular heart diseases and 2 types of SAS (obstructive sleep apnea (OSA) and central sleep apnea (CSA)) were examined. The effects of valve repair surgery on OSA and CSA was also investigated.


RESULTS
Polysomnography, echocardiography and right cardiac catheterization were used to study 150 severe HF patients with mitral valvular and/or aortic valvular diseases. Significant associations between SAS and age, gender, body mass index, or hypertension were observed. The value of the CSA-apnea index (AI) was significantly correlated with pulmonary capillary wedge pressure (PCWP) and mean pulmonary artery pressure (PAP). These associations were not identified for OSA-AI. Valve repair surgery was used to treat 74 patients with severe SAS. The treatment led to a significant improvement in PCWP and mean PAP, and CSA-AI, but not in OSA-AI.


CONCLUSIONS
These findings suggest close associations between CSA and cardiac function in HF patients with valvular heart diseases. Furthermore, improvement of cardiac function with valvular surgery reduces the severity of CSA in HF patients with valvular heart diseases.
Abe
Hidetoshi
H
Department of Cardiovascular Medicine, Shinshu University Graduate School of Medicine, Matsumoto, Japan.
Takahashi
Masafumi
M
Yaegashi
Hironobu
H
Eda
Seiichiro
S
Kitahara
Hiroto
H
Tsunemoto
Hideo
H
Kamikozawa
Mamoru
M
Koyama
Jun
J
Yamazaki
Kyohei
K
Ikeda
Uichi
U
D000368:Aged; D001021:Aortic Valve / Q000601:surgery; D006328:Cardiac Catheterization; D002404:Catheterization; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000150:complications*; D006349:Heart Valve Diseases / Q000150:complications* / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D017286:Polysomnography; D011669:Pulmonary Wedge Pressure; D020182:Sleep Apnea, Central / Q000150:complications* / Q000503:physiopathology; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000503:physiopathology