title: Prognostic impact of central sleep apnea in patients with heart failure.
abstract: BACKGROUND
  Central sleep apnea (CSA) is common in patients with heart failure (HF). Earlier studies investigating the influence of CSA on mortality in HF patients, however, have yielded contradictory results.
  
  
  RESULTS
  In a prospective study involving 267 patients with left ventricular (LV) ejection fractions ≤50%, we performed polysomnography and compared heart transplant-free survival rates between patients with no or mild CSA (apnea-hypopnea index [AHI] ≤15/h) and those with moderate CSA (AHI 15.1-30/h) or severe CSA (AHI >30/h). During 43 ± 18 months' mean follow-up, 67 patients (25%) died and 4 patients (1%) underwent heart transplantation. Multivariate Cox analysis identified age, male sex, chronic kidney disease, and decreased LV ejection fraction, but not moderate CSA or severe CSA, as predictors of transplant-free survival.
  
  
  CONCLUSIONS
  In patients with stable HF, moderate CSA as well as severe CSA do not appear to predict transplant-free survival independently from confounding factors.
authors.affiliation: Department of Cardiology, University Hospital of Marburg and Gießen, Marburg, Germany. Electronic address: grimmw@med.uni-marburg.de.
authors.forename: Wolfram
authors.initials: W
authors.lastname: Grimm
authors.affiliation: Department of Cardiology, University Hospital of Marburg and Gießen, Marburg, Germany.
authors.forename: Antonina
authors.initials: A
authors.lastname: Sosnovskaya
authors.affiliation: Institute for Medical Biometry and Epidemiology, Philipps-University Marburg, Marburg, Germany.
authors.forename: Nina
authors.initials: N
authors.lastname: Timmesfeld
authors.affiliation: Sleep Disorder Unit of the Department of Pneumology, University Hospital of Marburg and Gießen, Marburg, Germany.
authors.forename: Olaf
authors.initials: O
authors.lastname: Hildebrandt
authors.affiliation: Sleep Disorder Unit of the Department of Pneumology, University Hospital of Marburg and Gießen, Marburg, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Koehler
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis* / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography / Q000401:mortality / Q000639:trends; D011379:Prognosis; D011446:Prospective Studies; D020182:Sleep Apnea, Central / Q000175:diagnosis* / Q000401:mortality* / Q000503:physiopathology; D015996:Survival Rate / Q000639:trends
keywords: Central sleep apnea; heart failure; polysomnography; transplant-free survival