title: Tissue Doppler Imaging predicts central sleep apnea in patients with chronic heart failure: data from the Daunia Registry.
abstract: BACKGROUND
  Tissue Doppler imaging (TDI) is used to improve risk stratification in patients with chronic heart failure (CHF). So far, few studies have used this method to investigate the characteristics of subjects with CHF and Cheyne-Stokes breathing (CSB). The aim of this study was therefore to evaluate whether TDI assessment may predict the presence of CSB in patients with CHF.
  
  
  METHODS
  A total of 41 consecutive patients with CHF enrolled in the Daunia Heart Failure Registry underwent echocardiography assessment and nocturnal polygraphy to evaluate the presence of sleep apnea and CSB. Conventional echocardiography and TDI parameters were calculated. We have also quantified by TDI a combined index (EAS index) of diastolic and systolic performance: E'/(A' × S').
  
  
  RESULTS
  Subjects with evidence of CSB (N = 8) were characterized by lower values of A' (5·03 ± 2·64 vs. 7·88 ± 2·64 cm/s, P < 0·01). A' and EAS index values were related to Cheyne-Stokes episode rates (r = -0·49 and 0·52, P < 0·05 and <0·01 respectively), EAS index values also with the number of episodes of central apnea (r = 0·39, P < 0·05). A' values predicted the presence of CSB at poly-somnography examination with an OR 0·62 (95% CI 0·40-0·96, P < 0·05) even after correction for age and gender.
  
  
  CONCLUSIONS
  Tissue Doppler imaging values (A') are associated with the presence of sleep apnea at nocturnal polygraphy.
authors.affiliation: Cardiology Department, Ospedali Riuniti, Foggia, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Correale
authors.affiliation: Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
authors.forename: Natale Daniele
authors.initials: ND
authors.lastname: Brunetti
authors.affiliation: Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Forte
authors.affiliation: Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Passero
authors.affiliation: Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
authors.forename: Ilenia
authors.initials: I
authors.lastname: Monaco
authors.affiliation: Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
authors.forename: Armando
authors.initials: A
authors.lastname: Ferraretti
authors.affiliation: Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Totaro
authors.affiliation: Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
authors.forename: Giovanna Elisiana
authors.initials: GE
authors.lastname: Carpagnano
authors.affiliation: Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Foschino Barbaro
authors.affiliation: Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Di Biase
authors.affiliation: Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
authors.forename: Donato
authors.initials: D
authors.lastname: Lacedonia
mesh_terms: D000368:Aged; D002639:Cheyne-Stokes Respiration / Q000175:diagnosis* / Q000453:epidemiology; D002908:Chronic Disease; D015150:Echocardiography, Doppler; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017286:Polysomnography; D012042:Registries; D020182:Sleep Apnea, Central / Q000175:diagnosis* / Q000453:epidemiology; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology
keywords: A'; Cheyne-Stokes breathing; chronic heart failure; echocardiography; nocturnal polygraphy; tissue doppler imaging