Faizan Javed1, Renaud Tamisier2,3, Jean-Louis Pepin2,3, Martin R Cowie4, Karl Wegscheider5, Christiane Angermann6, Marie-Pia d'Ortho7, Erland Erdmann8, Anita K Simonds9, Virend K Somers10, Helmut Teschler11, Patrick Levy2,3, Jeff Armitstead1, Holger Woehrle12. 1. Clinical Science and Innovation, ResMed Asia Pacific Ltd, Sydney, NSW, Australia. 2. Pole Thorax et Vaisseaux CHU Grenoble-Alpes, Grenoble, France. 3. Laboratoire HP2, Inserm Université Grenoble-Alpes, Grenoble, France. 4. Imperial College London, London, UK. 5. Department of Medical Biometry and Epidemiology, University Medical Center Eppendorf, Hamburg, Germany. 6. Comprehensive Heart Failure Center, University Hospital and University of Würzburg, Würzburg, Germany. 7. University Paris Diderot, Sorbonne Paris Cité, Hôpital Bichat, Explorations Fonctionnelles, DHU, FIRE, Paris, France. 8. Heart Center, University of Cologne, Cologne, Germany. 9. Royal Brompton Hospital, London, UK. 10. Cardiovascular Facility, Mayo Clinic, Rochester, MN, USA. 11. Department of Pneumology, Ruhrlandklinik, West German Lung Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany. 12. Sleep and Ventilation Center Blaubeuren/Lung Center Ulm, Ulm, Germany.
Abstract
BACKGROUND AND OBJECTIVE: Increases in Cheyne-Stokes respiration (CSR) cycle length (CL), lung-to-periphery circulation time (LPCT) and time to peak flow (TTPF) may reflect impaired cardiac function. This retrospective analysis used an automatic algorithm to evaluate baseline CSR-related features and then determined whether these could be used to identify patients with systolic heart failure (HF) who experienced serious adverse events in the Treatment of Sleep-Disordered Breathing with Predominant Central Sleep Apnea by Adaptive Servo Ventilation in Patients with Heart Failure (SERVE-HF) substudy. METHODS: A total of 280 patients had overnight diagnostic polysomnography data available; an automated algorithm was applied to quantify CSR-related features. RESULTS: Median baseline CL, LPCT and TTPF were similar in the control (n = 152) and adaptive servo-ventilation (ASV, n = 156) groups. In both groups, CSR-related features were significantly longer in patients who did (n = 129) versus did not (n = 140) experience a primary endpoint event (all-cause death, life-saving cardiovascular intervention or unplanned hospitalization for worsening HF): CL, 61.1 versus 55.1 s (P = 0.002); LPCT, 36.5 versus 31.5 s (P < 0.001); TTPF, 15.20 versus 13.35 s (P < 0.001), respectively. This finding was independent of treatment allocation. CONCLUSION: Patients with systolic HF and central sleep apnoea who experienced serious adverse events had longer CSR CL, LPCT and TTPF. Future studies should examine an independent role for CSR-related features to enable risk stratification in systolic HF.
BACKGROUND AND OBJECTIVE: Increases in Cheyne-Stokes respiration (CSR) cycle length (CL), lung-to-periphery circulation time (LPCT) and time to peak flow (TTPF) may reflect impaired cardiac function. This retrospective analysis used an automatic algorithm to evaluate baseline CSR-related features and then determined whether these could be used to identify patients with systolic heart failure (HF) who experienced serious adverse events in the Treatment of Sleep-Disordered Breathing with Predominant Central Sleep Apnea by Adaptive Servo Ventilation in Patients with Heart Failure (SERVE-HF) substudy. METHODS: A total of 280 patients had overnight diagnostic polysomnography data available; an automated algorithm was applied to quantify CSR-related features. RESULTS: Median baseline CL, LPCT and TTPF were similar in the control (n = 152) and adaptive servo-ventilation (ASV, n = 156) groups. In both groups, CSR-related features were significantly longer in patients who did (n = 129) versus did not (n = 140) experience a primary endpoint event (all-cause death, life-saving cardiovascular intervention or unplanned hospitalization for worsening HF): CL, 61.1 versus 55.1 s (P = 0.002); LPCT, 36.5 versus 31.5 s (P < 0.001); TTPF, 15.20 versus 13.35 s (P < 0.001), respectively. This finding was independent of treatment allocation. CONCLUSION:Patients with systolic HF and central sleep apnoea who experienced serious adverse events had longer CSR CL, LPCT and TTPF. Future studies should examine an independent role for CSR-related features to enable risk stratification in systolic HF.
Authors: Jeremy E Orr; Indu Ayappa; Danny J Eckert; Jack L Feldman; Chandra L Jackson; Shahrokh Javaheri; Rami N Khayat; Jennifer L Martin; Reena Mehra; Matthew T Naughton; Winfried J Randerath; Scott A Sands; Virend K Somers; M Safwan Badr Journal: Am J Respir Crit Care Med Date: 2021-03-15 Impact factor: 21.405