AIMS: This study investigates the influence of cardiac resynchronisation therapy (CRT) on sleep disordered breathing (SDB) in patients with severe heart failure (HF). METHODS AND RESULTS: Seventy-seven patients with HF (19 females; 62.6+/-10 years) eligible for CRT were screened for presence, type, and severity of SDB before and after CRT initiation (5.3+/-3 months) using cardiorespiratory polygraphy. NYHA class, frequency of nycturia, cardiopulmonary exercise, 6-minute walking test results, and echocardiography parameters were obtained at baseline and follow-up. Central sleep apnoea (CSA) was documented in 36 (47%), obstructive sleep apnoea (OSA) in 26 (34%), and no SDB in 15 (19%) patients. CRT improved clinical and haemodynamic parameters. SDB parameters improved in CSA patients only (apnoea hypopnoea index: 31.2+/-15.5 to 17.3+/-13.7/h, p<0.001; SaO2min: 81.8+/-6.6 to 84.8+/-3.3%, p=0.02, desaturation: 6.5+/-2.3 to 5.5+/-0.8%, p=0.004). Daytime capillary pCO2 was significantly lower in CSA patients compared to those without SDB with a trend towards increase with CRT (35.5+/-4.2 to 37.9+/-5.7 mm Hg, ns). After classifying short term clinical and haemodynamic CRT effects, improved SDB parameters in CSA occurred in responders only. CONCLUSIONS: In patients with severe HF eligible for CRT, CSA is common and can be influenced by CRT, this improvement depends on good clinical and haemodynamic response to CRT.
AIMS: This study investigates the influence of cardiac resynchronisation therapy (CRT) on sleep disordered breathing (SDB) in patients with severe heart failure (HF). METHODS AND RESULTS: Seventy-seven patients with HF (19 females; 62.6+/-10 years) eligible for CRT were screened for presence, type, and severity of SDB before and after CRT initiation (5.3+/-3 months) using cardiorespiratory polygraphy. NYHA class, frequency of nycturia, cardiopulmonary exercise, 6-minute walking test results, and echocardiography parameters were obtained at baseline and follow-up. Central sleep apnoea (CSA) was documented in 36 (47%), obstructive sleep apnoea (OSA) in 26 (34%), and no SDB in 15 (19%) patients. CRT improved clinical and haemodynamic parameters. SDB parameters improved in CSA patients only (apnoea hypopnoea index: 31.2+/-15.5 to 17.3+/-13.7/h, p<0.001; SaO2min: 81.8+/-6.6 to 84.8+/-3.3%, p=0.02, desaturation: 6.5+/-2.3 to 5.5+/-0.8%, p=0.004). Daytime capillary pCO2 was significantly lower in CSA patients compared to those without SDB with a trend towards increase with CRT (35.5+/-4.2 to 37.9+/-5.7 mm Hg, ns). After classifying short term clinical and haemodynamic CRT effects, improved SDB parameters in CSA occurred in responders only. CONCLUSIONS: In patients with severe HF eligible for CRT, CSA is common and can be influenced by CRT, this improvement depends on good clinical and haemodynamic response to CRT.
Authors: Neil R Ward; Vitor Roldao; Martin R Cowie; Stuart D Rosen; Theresa A McDonagh; Anita K Simonds; Mary J Morrell Journal: Sleep Date: 2013-09-01 Impact factor: 5.849
Authors: Dominik Linz; Holger Woehrle; Thomas Bitter; Henrik Fox; Martin R Cowie; Michael Böhm; Olaf Oldenburg Journal: Clin Res Cardiol Date: 2015-04-23 Impact factor: 5.460
Authors: Olaf Oldenburg; Birgit Wellmann; Thomas Bitter; Henrik Fox; Anika Buchholz; Eric Freiwald; Dieter Horstkotte; Karl Wegscheider Journal: Clin Res Cardiol Date: 2018-04-13 Impact factor: 5.460
Authors: Lars Lüthje; Bernd Renner; Roger Kessels; Dirk Vollmann; Tobias Raupach; Bart Gerritse; Selcuk Tasci; Jörg O Schwab; Markus Zabel; Dieter Zenker; Peter Schott; Gerd Hasenfuss; Christina Unterberg-Buchwald; Stefan Andreas Journal: Eur J Heart Fail Date: 2009-01-12 Impact factor: 15.534