Cheyne-stokes respiration and prognosis in modern-treated congestive heart failure.
In patients with congestive heart failure (CHF), a high prevalence of sleep-disordered breathing has been described. Cheyne-Stokes respiration (CSR) is present in up to 40% of patients with CHF. During the last decade, the medical treatment has been substantially improved. This study was designed to analyze the prognosis of CSR in modern-treated patients with CHF. For this purposes, in 57 patients with CHF who received modern treatment, a 5-year follow-up after initial full night polysomnography was performed. The mean follow-up period was 38 +/- 18 months. Mean age was 62 +/- 13 years and the mean ejection fraction was 25 +/- 7 percent. Respiratory polygraphy revealed CSR with a respiratory disturbance index >5 per hour of sleep in 39 of 57 patients. Twelve patients died. CSR was only characterized by a tendency of worsening (log-rank test, p = 0.25). However, there was a significant difference toward positive outcome for patients who received cardiac resynchronization therapy (log-rank test, p = 0.036). Using Multivariate Cox's proportional hazard regression with the factors resynchronization and CSR, the effect of resynchronization was almost significant (p = 0.08). In conclusion, no significant change of Cheyne-Stokes prevalence can be found in our small group of modern-treated patients with CHF. Cardiac resynchronization therapy was associated with improved patient outcome.
Hagenah
Gerrit
G
Department of Internal Medicine, Georg-August-University Goettingen, Robert-Koch-Str 40, 37075 Goettingen, Germany. gerrit.hagenah@freenet.de
Zapf
Antonia
A
Schüttert
Jan Bernd
JB
D000368:Aged; D002304:Cardiac Pacing, Artificial; D002639:Cheyne-Stokes Respiration / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011379:Prognosis; D012189:Retrospective Studies; D012891:Sleep Apnea Syndromes / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D016896:Treatment Outcome