Prognostic Importance of Novel Oxygen Desaturation Metrics in Patients With Heart Failure and Central Sleep Apnea

Eiichi Watanabe, Ken Kiyono, Shojiro Matsui, Virend K. Somers, Kan Sano, Junichiro Hayano, Tomohide Ichikawa, Mayumi Kawai, Masahide Harada, Yukio Ozaki

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)131-137
Number of pages7
JournalJournal of Cardiac Failure
Volume23
Issue number2
DOIs
Publication statusPublished - 01-02-2017

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Central Sleep Apnea
Apnea
Heart Failure
Oxygen
Survivors
Sleep
Sleep Apnea Syndromes
Logistic Models
Regression Analysis
Mortality

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Watanabe, Eiichi ; Kiyono, Ken ; Matsui, Shojiro ; Somers, Virend K. ; Sano, Kan ; Hayano, Junichiro ; Ichikawa, Tomohide ; Kawai, Mayumi ; Harada, Masahide ; Ozaki, Yukio. / Prognostic Importance of Novel Oxygen Desaturation Metrics in Patients With Heart Failure and Central Sleep Apnea. In: Journal of Cardiac Failure. 2017 ; Vol. 23, No. 2. pp. 131-137.
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abstract = "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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Prognostic Importance of Novel Oxygen Desaturation Metrics in Patients With Heart Failure and Central Sleep Apnea. / Watanabe, Eiichi; Kiyono, Ken; Matsui, Shojiro; Somers, Virend K.; Sano, Kan; Hayano, Junichiro; Ichikawa, Tomohide; Kawai, Mayumi; Harada, Masahide; Ozaki, Yukio.

In: Journal of Cardiac Failure, Vol. 23, No. 2, 01.02.2017, p. 131-137.

Research output: Contribution to journalArticle

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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

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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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