title: Prospective Evaluation of Sleep Apnea as Manifestation of Heart Failure in Children.
abstract: In adults with heart failure, central sleep apnea (CSA), often manifested as Cheyne-Stokes respiration, is common, and has been associated with adverse outcome. Heart failure in children is commonly caused by dilated cardiomyopathy (DCM). It is unknown whether children with heart failure secondary to DCM have CSA, and whether CSA is related to the severity of heart failure. In this prospective observational study, 37 patients (<18 year) with heart failure secondary to DCM were included. They underwent polysomnography, clinical and laboratory evaluation and echocardiographic assessment. After a median follow-up time of 2 years, eight patients underwent heart transplantation. CSA (apnea-hypopnea index [AHI] ≥1) was found in 19 % of the patients. AHI ranged from 1.2 to 4.5/h. The occurrence of CSA was not related to the severity of heart failure. Three older patients showed a breathing pattern mimicking Cheyne-Stokes respiration, two of whom required heart transplantation. CSA was found in 19 % of the children with heart failure secondary to DCM. No relation was found with the severity of heart failure. In a small subset of children with severe DCM, a pattern mimicking Cheyne-Stokes respiration was registered.
authors.affiliation: Department of Pediatrics, Division of Pediatric Cardiology, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, Dr. Molewaterplein 60, Room Sp-2433, 3000 CB, Rotterdam, The Netherlands. s.denboer@erasmusmc.nl.
authors.forename: Susanna L
authors.initials: SL
authors.lastname: den Boer
authors.affiliation: Department of Pediatrics, Pediatric Intensive Care, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands. k.joosten@erasmusmc.nl.
authors.forename: Koen F M
authors.initials: KF
authors.lastname: Joosten
authors.affiliation: Department of Pediatrics, Pediatric Intensive Care, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands. s.vandenberg.1@erasmusmc.nl.
authors.forename: Sandra
authors.initials: S
authors.lastname: van den Berg
authors.affiliation: Department of Pediatrics, Division of Pediatric Cardiology, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands. a.p.backx@amc.uva.nl.
authors.forename: Ad P C M
authors.initials: AP
authors.lastname: Backx
authors.affiliation: Department of Pediatrics, Division of Pediatric Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands. ronald.tanke@radboudumc.nl.
authors.forename: Ronald B
authors.initials: RB
authors.lastname: Tanke
authors.affiliation: Department of Pediatrics, Division of Pediatric Cardiology, Beatrix Children's Hospital, University Medical Center Groningen, Groningen, The Netherlands. g.j.du.marchie.sarvaas@umcg.nl.
authors.forename: Gideon J du Marchie
authors.initials: GJ
authors.lastname: Sarvaas
authors.affiliation: Department of Pediatrics, Division of Pediatric Cardiology, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, Dr. Molewaterplein 60, Room Sp-2433, 3000 CB, Rotterdam, The Netherlands. w.a.helbing@erasmusmc.nl.
authors.forename: Willem A
authors.initials: WA
authors.lastname: Helbing
authors.affiliation: Department of Pediatrics, Division of Pediatric Cardiology, Free University Medical Center, Amsterdam, The Netherlands. l.rammeloo@vumc.nl.
authors.forename: Lukas A J
authors.initials: LA
authors.lastname: Rammeloo
authors.affiliation: Department of Pediatrics, Division of Pediatric Cardiology, Leiden University Medical Center, Leiden, The Netherlands. a.d.j.ten_harkel@lumc.nl.
authors.forename: Arend D J
authors.initials: AD
authors.lastname: ten Harkel
authors.affiliation: Department of Pediatrics, Division of Pediatric Cardiology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands. g.vaniperen@umcutrecht.nl.
authors.forename: Gabriëlle G
authors.initials: GG
authors.lastname: van Iperen
authors.affiliation: Department of Pediatrics, Division of Pediatric Cardiology, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, Dr. Molewaterplein 60, Room Sp-2433, 3000 CB, Rotterdam, The Netherlands. m.dalinghaus@erasmusmc.nl.
authors.forename: Michiel
authors.initials: M
authors.lastname: Dalinghaus
mesh_terms: D000293:Adolescent; D002311:Cardiomyopathy, Dilated / Q000150:complications*; D002639:Cheyne-Stokes Respiration / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000453:epidemiology* / Q000209:etiology; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D009426:Netherlands; D017286:Polysomnography; D011446:Prospective Studies; D012720:Severity of Illness Index; D020182:Sleep Apnea, Central / Q000453:epidemiology*
keywords: Central sleep apnea; Dilated cardiomyopathy; Pediatric; Polysomnography