TY - JOUR
T1 - Prognostic Importance of Novel Oxygen Desaturation Metrics in Patients With Heart Failure and Central Sleep Apnea
AU - Watanabe, Eiichi
AU - Kiyono, Ken
AU - Matsui, Shojiro
AU - Somers, Virend K.
AU - Sano, Kan
AU - Hayano, Junichiro
AU - Ichikawa, Tomohide
AU - Kawai, Mayumi
AU - Harada, Masahide
AU - Ozaki, Yukio
N1 - Funding Information:
EW is supported by a grant from the Suzuken Memorial Foundation and JSPS KAKENHI grant no. 26461094. KK is supported by JSPS KAKENHI 23700544.VKS is supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health under award no. R01HL065176. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Background Sleep-disordered breathing, particularly central sleep apnea (CSA), is highly prevalent in heart failure (HF) and an independent prognostic marker. We assessed the hypothesis that an increased hypoxemic burden during sleep may have greater prognostic value than the frequency of apneic and hypopneic episodes. Methods and Results We prospectively conducted overnight cardiorespiratory polygraphy on consecutive HF patients referred to our hospital from 2008 to 2011. We studied CSA defined by an apnea-hypopnea index (AHI) of ≥5 events/h with >75% of all events being central in origin. We determined the AHI, proportion of the sleep time with SpO2 <90% (T90%), and proportion of the recording time that 4% desaturation events occurred (4%POD). We studied 112 HF patients with either systolic or diastolic dysfunction. During a follow-up period of 37 ± 25 months, 32 patients (29%) died. Nonsurvivors had a higher 4%POD compared with survivors (11 ± 6.4% vs 19 ± 13%; P = .001), but did not differ significantly from survivors regarding AHI and T90%. An adjusted logistic regression analysis revealed that the 4%POD was the best independent predictor of mortality. Conclusions The 4%POD, a novel metric for the nocturnal hypoxemic burden, is an independent prognostic marker in HF patients affected by CSA.
AB - Background Sleep-disordered breathing, particularly central sleep apnea (CSA), is highly prevalent in heart failure (HF) and an independent prognostic marker. We assessed the hypothesis that an increased hypoxemic burden during sleep may have greater prognostic value than the frequency of apneic and hypopneic episodes. Methods and Results We prospectively conducted overnight cardiorespiratory polygraphy on consecutive HF patients referred to our hospital from 2008 to 2011. We studied CSA defined by an apnea-hypopnea index (AHI) of ≥5 events/h with >75% of all events being central in origin. We determined the AHI, proportion of the sleep time with SpO2 <90% (T90%), and proportion of the recording time that 4% desaturation events occurred (4%POD). We studied 112 HF patients with either systolic or diastolic dysfunction. During a follow-up period of 37 ± 25 months, 32 patients (29%) died. Nonsurvivors had a higher 4%POD compared with survivors (11 ± 6.4% vs 19 ± 13%; P = .001), but did not differ significantly from survivors regarding AHI and T90%. An adjusted logistic regression analysis revealed that the 4%POD was the best independent predictor of mortality. Conclusions The 4%POD, a novel metric for the nocturnal hypoxemic burden, is an independent prognostic marker in HF patients affected by CSA.
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U2 - 10.1016/j.cardfail.2016.09.004
DO - 10.1016/j.cardfail.2016.09.004
M3 - Article
C2 - 27615064
AN - SCOPUS:84999635761
VL - 23
SP - 131
EP - 137
JO - Journal of Cardiac Failure
JF - Journal of Cardiac Failure
SN - 1071-9164
IS - 2
ER -