title: Impact of Obstructive Sleep Apnoea on Heart Failure with Preserved Ejection Fraction.
abstract: BACKGROUND
  The impact of obstructive sleep apnoea on heart failure with preserved ejection fraction is unknown.
  
  
  METHODS
  Fifty-eight patients who had heart failure with a left ventricular ejection fraction; ≥50% underwent a sleep study. Brain natriuretic peptide (BNP) levels were determined at enrolment and at one, six, 12 and 36 months after enrolment.
  
  
  RESULTS
  Obstructive sleep apnoea was found in 39 patients (67%), and they were all subsequently treated with continuous positive airway pressure. Echocardiography at admission showed that E/E' tended to be higher in the 39 patients with, than in the 19 patients without, obstructive sleep apnoea (15.0±3.6 vs 12.1±1.9, respectively, P=0.05). The median BNP levels at enrolment were similar in patients with and without obstructive sleep apnoea [median (interquartile range): 444 (233-752) vs 316 (218-703) pg/ml]. Although BNP levels decreased over time in both groups, the reduction was less pronounced in patients with obstructive sleep apnoea (P<0.05). Consequently, BNP levels were higher in patients with sleep apnoea at six months, [221 (137-324) vs 76 (38-96) pg/ml, P<0.05], 12 months [123 (98-197) vs 52 (38-76) pg/ml, P<0.05] and 36 months [115 (64-174) vs 56 (25-74) pg/ml, P<0.05].
  
  
  CONCLUSIONS
  Obstructive sleep apnoea, even when treated appropriately, may worsen long-term cardiac function and outcomes in patients who have heart failure with preserved ejection fraction.
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University, 321-0293 Mibu, Japan. Electronic address: takuoari@dokkyomed.ac.jp.
authors.forename: Takuo
authors.initials: T
authors.lastname: Arikawa
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University, 321-0293 Mibu, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Toyoda
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University, 321-0293 Mibu, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Haruyama
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University, 321-0293 Mibu, Japan.
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Amano
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University, 321-0293 Mibu, Japan.
authors.forename: Shu
authors.initials: S
authors.lastname: Inami
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University, 321-0293 Mibu, Japan.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Otani
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University, 321-0293 Mibu, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Sakuma
authors.affiliation: Department of Cardiology, Koshigaya Hospital, Dokkyo Medical University, 343-8555 Koshigaya, Japan.
authors.forename: Isao
authors.initials: I
authors.lastname: Taguchi
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University, 321-0293 Mibu, Japan.
authors.forename: Shichiro
authors.initials: S
authors.lastname: Abe
authors.affiliation: Department of Cardiovascular Medicine, Saga University Faculty of Medicine, 849-8501 Saga, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Node
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University, 321-0293 Mibu, Japan.
authors.forename: Teruo
authors.initials: T
authors.lastname: Inoue
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004452:Echocardiography; D006333:Heart Failure / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D020181:Sleep Apnea, Obstructive / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D013318:Stroke Volume
chemical_list: D020097:Natriuretic Peptide, Brain
keywords: Brain natriuretic peptide; Heart failure with preserved ejection fraction; Left ventricular diastolic function; Long-term prognosis; Obstructive sleep apnoea