Implications of Cheyne-Stokes breathing in advanced systolic heart failure.
BACKGROUND
Cheyne-Stokes breathing (CSB) has been associated with heart failure (HF) patients for many years; however, its true prevalence and its prognostic implications are still obscure.


OBJECTIVE
The goal of this study was to investigate the prevalence and the possible prognostic implications of nocturnal CSB in advanced heart failure patients.


METHODS
We performed single night full polysomonography ambulatory sleep studies in 71 HF patients. We analyzed the patients' sleep studies, clinical and laboratory data, and 6 month mortality.


RESULTS
A total of 71 chronic systolic HF patients were analyzed, 60 males, 11 females, age 65 +/- 13 years. Mean left ventricular ejection fraction was 27% +/- 11%. Short episodes of CSB (at least 3 min duration) were present in all patients, and mean CSB duration was 1 hour. CSB duration was associated significantly with both high serum levels of N-terminal prohormone brain natriuretic peptide (NT-proBNP) as well as with 6 month mortality. Log CSB time had a significant correlation with log NT-proBNP (r = 0.5, P<.0001). Based on median CSB duration, the Kaplan-Meier survival curve analysis showed significant association with 6 month mortality (P = .03).


CONCLUSIONS
CSB prevalence in advanced HF patients is higher than previously reported and is associated with increased serum levels of NT-proBNP and higher 6 month mortality.
Amir
Offer
O
Department of Cardiology, Lin Medical Center and Lady Davis Carmel Medical Center, Yocheced 10 street, Haifa, Israel. offeram@012.net.il
Reisfeld
Daniel
D
Sberro
Hila
H
Paz
Hagar
H
Mintz
Shira
S
Lewis
Basil S
BS
D000368:Aged; D002639:Cheyne-Stokes Respiration / Q000453:epidemiology* / Q000503:physiopathology; D018450:Disease Progression; D015716:Electrocardiography, Ambulatory; D005260:Female; D006305:Health Status Indicators; D054143:Heart Failure, Systolic / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D007557:Israel / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D020097:Natriuretic Peptide, Brain; D010446:Peptide Fragments; D017286:Polysomnography; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes; D013223:Statistics as Topic; D013318:Stroke Volume; D016277:Ventricular Function, Left
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain