Central sleep apnoea and inflammation are independently associated with arrhythmia in patients with heart failure

Kan Sano, Eiichi Watanabe, Junichiro Hayano, Yuuki Mieno, Yoshihiro Sobue, Mayumi Yamamoto, Tomohide Ichikawa, Hiroki Sakakibara, Kazuyoshi Imaizumi, Yukio Ozaki

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

AimsWe examined whether the severity of central sleep apnoea (CSA) and the level of C-reactive protein are associated with the prevalence and complexity of arrhythmias, and whether these factors contribute to increased risk of nocturnal sudden death.Methods and resultsWe prospectively examined 178 patients (age 70 ± 1 years) who were admitted to our hospital due to worsening heart failure. We recorded a simultaneous overnight cardiorespiratory polygraph and Holter ECG. Obstructive sleep apnoea was excluded and patients were dichotomized based on the median value of the central apnoea index (CAI) of 7.5/h. The prevalence and complexity of arrhythmias were compared between daytime (06:00 h to 15:00 h) and night-time (21:00 h to 06:00 h). A multivariate logistic regression analysis revealed that the CAI was associated with prevalence of atrial fibrillation (AF) [odds ratio 1.03, 95% confidence interval (CI) 1.02-2.51)] and sinus pause during the night-time period (1.12, 95% CI 1.08-1.35). The CAI and C-reactive protein were independently associated with non-sustained ventricular tachycardia during both daytime (1.22, 95% CI 1.00-6.92; and 5.82, 2.58-56.1, respectively) and night-time periods (3.57, 95% CI 1.06-13.1; and 10.7, 3.30-44.4, respectively). During a mean follow-up period of 22 months, 30 (17%) patients had cardiovascular deaths and the CSA was an independent predictor (hazard ratio 1.29, 95% CI 1.16-2.32); only 5 (2.8%) of them died due to ventricular tachyarrhythmia, occurring during wakefulness.ConclusionsWe demonstrated that the severity of CSA and C-reactive protein levels are independently associated with the prevalence and complexity of arrhythmias. CSA was associated with increased mortality risk, but it was not related directly to nocturnal death due to ventricular tachyarrhythmia.

Original languageEnglish
Pages (from-to)1003-1010
Number of pages8
JournalEuropean Journal of Heart Failure
Volume15
Issue number9
DOIs
Publication statusPublished - 01-09-2013

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Central Sleep Apnea
Cardiac Arrhythmias
Heart Failure
Inflammation
Confidence Intervals
C-Reactive Protein
Tachycardia
Wakefulness
Obstructive Sleep Apnea
Ventricular Tachycardia
Sudden Death
Atrial Fibrillation
Electrocardiography
Logistic Models
Odds Ratio
Regression Analysis
Mortality

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Sano, Kan ; Watanabe, Eiichi ; Hayano, Junichiro ; Mieno, Yuuki ; Sobue, Yoshihiro ; Yamamoto, Mayumi ; Ichikawa, Tomohide ; Sakakibara, Hiroki ; Imaizumi, Kazuyoshi ; Ozaki, Yukio. / Central sleep apnoea and inflammation are independently associated with arrhythmia in patients with heart failure. In: European Journal of Heart Failure. 2013 ; Vol. 15, No. 9. pp. 1003-1010.
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abstract = "AimsWe examined whether the severity of central sleep apnoea (CSA) and the level of C-reactive protein are associated with the prevalence and complexity of arrhythmias, and whether these factors contribute to increased risk of nocturnal sudden death.Methods and resultsWe prospectively examined 178 patients (age 70 ± 1 years) who were admitted to our hospital due to worsening heart failure. We recorded a simultaneous overnight cardiorespiratory polygraph and Holter ECG. Obstructive sleep apnoea was excluded and patients were dichotomized based on the median value of the central apnoea index (CAI) of 7.5/h. The prevalence and complexity of arrhythmias were compared between daytime (06:00 h to 15:00 h) and night-time (21:00 h to 06:00 h). A multivariate logistic regression analysis revealed that the CAI was associated with prevalence of atrial fibrillation (AF) [odds ratio 1.03, 95{\%} confidence interval (CI) 1.02-2.51)] and sinus pause during the night-time period (1.12, 95{\%} CI 1.08-1.35). The CAI and C-reactive protein were independently associated with non-sustained ventricular tachycardia during both daytime (1.22, 95{\%} CI 1.00-6.92; and 5.82, 2.58-56.1, respectively) and night-time periods (3.57, 95{\%} CI 1.06-13.1; and 10.7, 3.30-44.4, respectively). During a mean follow-up period of 22 months, 30 (17{\%}) patients had cardiovascular deaths and the CSA was an independent predictor (hazard ratio 1.29, 95{\%} CI 1.16-2.32); only 5 (2.8{\%}) of them died due to ventricular tachyarrhythmia, occurring during wakefulness.ConclusionsWe demonstrated that the severity of CSA and C-reactive protein levels are independently associated with the prevalence and complexity of arrhythmias. CSA was associated with increased mortality risk, but it was not related directly to nocturnal death due to ventricular tachyarrhythmia.",
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Central sleep apnoea and inflammation are independently associated with arrhythmia in patients with heart failure. / Sano, Kan; Watanabe, Eiichi; Hayano, Junichiro; Mieno, Yuuki; Sobue, Yoshihiro; Yamamoto, Mayumi; Ichikawa, Tomohide; Sakakibara, Hiroki; Imaizumi, Kazuyoshi; Ozaki, Yukio.

In: European Journal of Heart Failure, Vol. 15, No. 9, 01.09.2013, p. 1003-1010.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Central sleep apnoea and inflammation are independently associated with arrhythmia in patients with heart failure

AU - Sano, Kan

AU - Watanabe, Eiichi

AU - Hayano, Junichiro

AU - Mieno, Yuuki

AU - Sobue, Yoshihiro

AU - Yamamoto, Mayumi

AU - Ichikawa, Tomohide

AU - Sakakibara, Hiroki

AU - Imaizumi, Kazuyoshi

AU - Ozaki, Yukio

PY - 2013/9/1

Y1 - 2013/9/1

N2 - AimsWe examined whether the severity of central sleep apnoea (CSA) and the level of C-reactive protein are associated with the prevalence and complexity of arrhythmias, and whether these factors contribute to increased risk of nocturnal sudden death.Methods and resultsWe prospectively examined 178 patients (age 70 ± 1 years) who were admitted to our hospital due to worsening heart failure. We recorded a simultaneous overnight cardiorespiratory polygraph and Holter ECG. Obstructive sleep apnoea was excluded and patients were dichotomized based on the median value of the central apnoea index (CAI) of 7.5/h. The prevalence and complexity of arrhythmias were compared between daytime (06:00 h to 15:00 h) and night-time (21:00 h to 06:00 h). A multivariate logistic regression analysis revealed that the CAI was associated with prevalence of atrial fibrillation (AF) [odds ratio 1.03, 95% confidence interval (CI) 1.02-2.51)] and sinus pause during the night-time period (1.12, 95% CI 1.08-1.35). The CAI and C-reactive protein were independently associated with non-sustained ventricular tachycardia during both daytime (1.22, 95% CI 1.00-6.92; and 5.82, 2.58-56.1, respectively) and night-time periods (3.57, 95% CI 1.06-13.1; and 10.7, 3.30-44.4, respectively). During a mean follow-up period of 22 months, 30 (17%) patients had cardiovascular deaths and the CSA was an independent predictor (hazard ratio 1.29, 95% CI 1.16-2.32); only 5 (2.8%) of them died due to ventricular tachyarrhythmia, occurring during wakefulness.ConclusionsWe demonstrated that the severity of CSA and C-reactive protein levels are independently associated with the prevalence and complexity of arrhythmias. CSA was associated with increased mortality risk, but it was not related directly to nocturnal death due to ventricular tachyarrhythmia.

AB - AimsWe examined whether the severity of central sleep apnoea (CSA) and the level of C-reactive protein are associated with the prevalence and complexity of arrhythmias, and whether these factors contribute to increased risk of nocturnal sudden death.Methods and resultsWe prospectively examined 178 patients (age 70 ± 1 years) who were admitted to our hospital due to worsening heart failure. We recorded a simultaneous overnight cardiorespiratory polygraph and Holter ECG. Obstructive sleep apnoea was excluded and patients were dichotomized based on the median value of the central apnoea index (CAI) of 7.5/h. The prevalence and complexity of arrhythmias were compared between daytime (06:00 h to 15:00 h) and night-time (21:00 h to 06:00 h). A multivariate logistic regression analysis revealed that the CAI was associated with prevalence of atrial fibrillation (AF) [odds ratio 1.03, 95% confidence interval (CI) 1.02-2.51)] and sinus pause during the night-time period (1.12, 95% CI 1.08-1.35). The CAI and C-reactive protein were independently associated with non-sustained ventricular tachycardia during both daytime (1.22, 95% CI 1.00-6.92; and 5.82, 2.58-56.1, respectively) and night-time periods (3.57, 95% CI 1.06-13.1; and 10.7, 3.30-44.4, respectively). During a mean follow-up period of 22 months, 30 (17%) patients had cardiovascular deaths and the CSA was an independent predictor (hazard ratio 1.29, 95% CI 1.16-2.32); only 5 (2.8%) of them died due to ventricular tachyarrhythmia, occurring during wakefulness.ConclusionsWe demonstrated that the severity of CSA and C-reactive protein levels are independently associated with the prevalence and complexity of arrhythmias. CSA was associated with increased mortality risk, but it was not related directly to nocturnal death due to ventricular tachyarrhythmia.

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