title: Impact of predischarge nocturnal pulse oximetry (sleep-disordered breathing) on postdischarge clinical outcomes in hospitalized patients with left ventricular systolic dysfunction after acute decompensated heart failure.
abstract: Stratifying patients at a high risk for readmission and mortality before their discharge after acute decompensated heart failure (ADHF) is important. Although sleep-disordered breathing (SDB) is prevalent in patients with chronic heart failure, only few studies have investigated the impact of SDB on hospitalized patients with left ventricular (LV) systolic dysfunction after ADHF. Thus, we assessed the prevalence of SDB using nocturnal pulse oximetry and the relation between SDB and clinical events in this patient group. One hundred consecutive patients with LV systolic dysfunction who were hospitalized for ADHF were enrolled in the study. Predischarge nocturnal oximetry was performed to determine if they had SDB (defined as an oxygen desaturation index of ≥5 events/hour with ≥4% decrease in saturation level). Data on death and readmission for ADHF were collected. Forty-one patients had SDB. Complete outcome data were collected in the mean follow-up period of 14.2 months during which 33 events occurred. On multivariate Cox proportional hazards regression analysis, the presence of SDB was a significant independent predictor of postdischarge readmission and mortality (hazard ratio 2.93, p = 0.006). In conclusion, SDB, as determined by predischarge nocturnal oximetry, is prevalent and is an independent predictor of the combined end point of readmission and mortality in hospitalized patients with LV systolic dysfunction after ADHF.
authors.affiliation: Department of Cardiology, Juntendo University Graduate School of Medicine, Tokyo, Japan; Nihonbashi Cardiology Clinic, Tokyo, Japan.
authors.forename: Takayasu
authors.initials: T
authors.lastname: Ohmura
authors.affiliation: Department of Cardiology, Juntendo University Graduate School of Medicine, Tokyo, Japan; Nihonbashi Cardiology Clinic, Tokyo, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Iwama
authors.affiliation: Department of Cardiology, Juntendo University Graduate School of Medicine, Tokyo, Japan; Cardio-Respiratory Sleep Medicine, Department of Cardiology, Juntendo University Graduate School of Medicine, Tokyo, Japan. Electronic address: kasai-t@mx6.nisiq.net.
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Kasai
authors.affiliation: Department of Cardiology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Kato
authors.affiliation: Department of Cardiology, Juntendo University Graduate School of Medicine, Tokyo, Japan; Cardio-Respiratory Sleep Medicine, Department of Cardiology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
authors.forename: Shoko
authors.initials: S
authors.lastname: Suda
authors.affiliation: Department of Cardiology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
authors.forename: Atsutoshi
authors.initials: A
authors.lastname: Takagi
authors.affiliation: Department of Cardiology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications / Q000401:mortality / Q000503:physiopathology*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010092:Oximetry / Q000379:methods*; D010359:Patient Readmission; D015995:Prevalence; D011379:Prognosis; D012891:Sleep Apnea Syndromes / Q000503:physiopathology*; D016019:Survival Analysis; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000401:mortality / Q000503:physiopathology*