BACKGROUND: Periodic Breathing (PB, waxing and waning of tidal volume in which hyperventilation alternates with periods of apnoea or hypopnoea), is common during sleep and wakefulness in patients with Heart Failure (HF) and may increase mortality. AIM: To assess the effect of short-term, day-time PB on prognosis, in HF patients. METHODS: We prospectively studied 380 consecutive HF referrals who had a 10 min, supine day-time respiratory recording. We related PB (adjusted for known predictors) to total cardiac mortality, during a median follow-up of 41 months. RESULTS: Day-time PB occurred in 145/380 patients who had more severe HF and more compromised left ventricular function (p<0.005). Survival curves began to separate after 10 months and diverged steadily over the next 4 years with a cumulative risk of 41% (PB) vs 26% (No-PB), p=0.002. PB was independently predictive of increased cardiac mortality when entered into a clinical prognostic model (including NYHA Class, LVEF, LVEDD, Systolic Arterial Pressure, beta-blocker treatment, peak VO2 and blood urea) with a RR: 1.8, 95% CI 1.20-2.81. CONCLUSION: In advanced HF the presence of PB during a short day-time recording adds to known predictors of cardiac mortality. This may have practical implications for trials of HF therapy.
BACKGROUND: Periodic Breathing (PB, waxing and waning of tidal volume in which hyperventilation alternates with periods of apnoea or hypopnoea), is common during sleep and wakefulness in patients with Heart Failure (HF) and may increase mortality. AIM: To assess the effect of short-term, day-time PB on prognosis, in HF patients. METHODS: We prospectively studied 380 consecutive HF referrals who had a 10 min, supine day-time respiratory recording. We related PB (adjusted for known predictors) to total cardiac mortality, during a median follow-up of 41 months. RESULTS: Day-time PB occurred in 145/380 patients who had more severe HF and more compromised left ventricular function (p<0.005). Survival curves began to separate after 10 months and diverged steadily over the next 4 years with a cumulative risk of 41% (PB) vs 26% (No-PB), p=0.002. PB was independently predictive of increased cardiac mortality when entered into a clinical prognostic model (including NYHA Class, LVEF, LVEDD, Systolic Arterial Pressure, beta-blocker treatment, peak VO2 and blood urea) with a RR: 1.8, 95% CI 1.20-2.81. CONCLUSION: In advanced HF the presence of PB during a short day-time recording adds to known predictors of cardiac mortality. This may have practical implications for trials of HF therapy.
Authors: Adelita Tinoco; Barbara J Drew; Xiao Hu; David Mortara; Bruce A Cooper; Michele M Pelter Journal: Ann Noninvasive Electrocardiol Date: 2017-06-15 Impact factor: 1.468
Authors: Offer Amir; Deganit Barak-Shinar; Rafael Wolff; Hagar Paz; Guy Dori; Frank W Smart; Basil S Lewis Journal: Sleep Breath Date: 2010-12-02 Impact factor: 2.816
Authors: Elisa Perger; Toru Inami; Owen D Lyons; Hisham Alshaer; Stephanie Smith; John S Floras; Alexander G Logan; Michael Arzt; Joaquin Duran Cantolla; Diego Delgado; Michael Fitzpatrick; John Fleetham; Takatoshi Kasai; R John Kimoff; Richard S T Leung; Geraldo Lorenzi Filho; Pierre Mayer; Lisa Mielniczuk; Debra L Morrison; Gianfranco Parati; Sairam Parthasarathy; Stefania Redolfi; Clodagh M Ryan; Frederic Series; George A Tomlinson; Anna Woo; T Douglas Bradley Journal: J Clin Sleep Med Date: 2017-11-15 Impact factor: 4.062
Authors: Andrea Mortara; Gian Domenico Pinna; Paul Johnson; Roberto Maestri; Soccorso Capomolla; Maria Teresa La Rovere; Piotr Ponikowski; Luigi Tavazzi; Peter Sleight Journal: Eur J Heart Fail Date: 2009-03 Impact factor: 15.534
Authors: Gian Domenico Pinna; Roberto Maestri; Andrea Mortara; Paul Johnson; David Andrews; Piotr Ponikowski; Tomasz Witkowski; Elena Robbi; Maria Teresa La Rovere; Peter Sleight Journal: Eur J Heart Fail Date: 2009-02-03 Impact factor: 15.534
Authors: Charles J Lynch; Benjamin M Silver; Marc J Dubin; Alex Martin; Henning U Voss; Rebecca M Jones; Jonathan D Power Journal: Nat Commun Date: 2020-10-20 Impact factor: 14.919