title: Prevalence and Impact of Sleep Disordered Breathing in Patients with Severe Aortic Stenosis.
abstract: BACKGROUND
  Unlike the well-established association between sleep disordered breathing (SDB) and chronic heart failure, the relationship between SDB and severe aortic stenosis (AS) is not well investigated. Given the increasing prevalence of AS, and the improving prognosis of high risk AS patients attributable to transcatheter aortic valve implantation (TAVI), the prevalence and impact of SDB needs to be better understood.
  
  
  RESULTS
  In this study, 140 patients with severe AS underwent polygraphy prior to TAVI. Clinical and hemodynamic parameters were recorded. Patients were followed for 573±405 days. We found that 99/140 patients (71%) had SDB with a mean apnoea-hypopnoea-index of 24±17/h. SDB was mild in 27%, moderate in 23% and severe in 21% of patients. In addition, 35 patients (25%) had obstructive sleep apnoea (OSA), whereas 64 patients (46%) had central sleep apnoea (CSA). Patients with OSA had predominantly mild SDB (20/38 pts.), and patients with CSA mostly had severe SDB (24/29 pts.). The prevalence and distribution of OSA and CSA were independent of left ventricular function. Overall, 1 and 2 year survival rates (74% and 71%, resp.) did not differ significantly between patients without SDB or those with OSA and CSA (p=0.81).
  
  
  CONCLUSIONS
  SDB, with a preponderance of CSA, was found to be highly prevalent in patients with high-grade AS scheduled for TAVI. SDB prevalence was independent of left ventricular function. Mortality after TAVI was not influenced by the type or severity of SDB.
authors.affiliation: Medizinische Klinik und Poliklinik II, Universitätsklinik Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Linhart
authors.affiliation: Medizinische Klinik und Poliklinik II, Universitätsklinik Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany.
authors.forename: Jan-Malte
authors.initials: JM
authors.lastname: Sinning
authors.affiliation: Medizinische Klinik und Poliklinik II, Universitätsklinik Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Ghanem
authors.affiliation: Medizinische Klinik und Poliklinik II, Universitätsklinik Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany.
authors.forename: Finny J
authors.initials: FJ
authors.lastname: Kozhuppakalam
authors.affiliation: Medizinische Klinik und Poliklinik II, Universitätsklinik Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Fistéra
authors.affiliation: Medizinische Klinik und Poliklinik II, Universitätsklinik Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Hammerstingl
authors.affiliation: Medizinische Klinik und Poliklinik II, Universitätsklinik Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany.
authors.forename: Carmen
authors.initials: C
authors.lastname: Pizarro
authors.affiliation: Medizinische Klinik und Poliklinik II, Universitätsklinik Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany.
authors.forename: Eberhard
authors.initials: E
authors.lastname: Grube
authors.affiliation: Medizinische Klinik und Poliklinik II, Universitätsklinik Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany.
authors.forename: Nikos
authors.initials: N
authors.lastname: Werner
authors.affiliation: Medizinische Klinik und Poliklinik II, Universitätsklinik Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Nickenig
authors.affiliation: Medizinische Klinik und Poliklinik II, Universitätsklinik Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Skowasch
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015995:Prevalence; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000401:mortality / Q000503:physiopathology; D065467:Transcatheter Aortic Valve Replacement