title: Valve repair improves central sleep apnea in heart failure patients with valvular heart diseases.
abstract: 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.
authors.affiliation: Department of Cardiovascular Medicine, Shinshu University Graduate School of Medicine, Matsumoto, Japan.
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Abe
authors.forename: Masafumi
authors.initials: M
authors.lastname: Takahashi
authors.forename: Hironobu
authors.initials: H
authors.lastname: Yaegashi
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Eda
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kitahara
authors.forename: Hideo
authors.initials: H
authors.lastname: Tsunemoto
authors.forename: Mamoru
authors.initials: M
authors.lastname: Kamikozawa
authors.forename: Jun
authors.initials: J
authors.lastname: Koyama
authors.forename: Kyohei
authors.initials: K
authors.lastname: Yamazaki
authors.forename: Uichi
authors.initials: U
authors.lastname: Ikeda
mesh_terms: 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