Beyond the Apnea–Hypopnea Index—Prognostic Value of Other Elements of Polysomnography to Describe Sleep-disordered Breathing in Heart Failure

2009 ◽  
Vol 6 (2) ◽  
pp. 68-71 ◽  
Author(s):  
Philip B Adamson ◽  
Keyword(s):  
Heart Failure ◽  
Prognostic Value ◽  
Sleep Disordered Breathing ◽  
Apnea Hypopnea Index ◽  
Disordered Breathing

Beyond the Apnoea–Hypopnoea Index – Prognostic Value of Other Elements of Polysomnography to Describe Sleep-disordered Breathing in Heart Failure

2009 ◽  
Vol 5 (2) ◽  
pp. 53
Author(s):  
Philip B Adamson ◽  
Keyword(s):  
Heart Failure ◽  
Standard Method ◽  
Patient Population ◽  
Prognostic Value ◽  
Sleep Disordered Breathing ◽  
Treatment Success ◽  
Multiple Components ◽  
Severity Of The Disease ◽  
Disordered Breathing

There is increasing appreciation of the prevalence of sleep-disordered breathing (SDP) in heart failure. As we examine this patient population, the difficulties of determining success in the treatment of SDB are becoming evident. The apnoea–hypopnoea index (AHI) is the standard method of measuring both the severity of the disease and treatment success, but in itself is a composite of multiple components. This article examines both current and developing measurements in the treatment of SDB.

scholarly journals Hypercapnic ventilatory response in heart failure patients with central sleep-disordered breathing

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
F Roder ◽  
M Potratz ◽  
C Sohns ◽  
V Rudolph ◽  
H Fox
Keyword(s):  
Heart Failure ◽  
Sleep Disordered Breathing ◽  
Ventilatory Response ◽  
Guideline Recommendation ◽  
Apnea Hypopnea Index ◽  
Heart Failure Patients ◽  
Hypercapnic Ventilatory Response ◽  
Worse Prognosis ◽  
Disordered Breathing

Abstract Background Sleep-disordered breathing (SDB) is a highly common comorbidity in heart failure (HF) patients and appears mainly as obstructive SDB, or central SDB. SDB has been shown to deteriorate quality of life in HF patients, but its presence is also associated with worse prognosis. SDB severity has been shown to mirror HF level and hereby hypercapnic ventilatory response (HCVR) depicts ventilation instability which furthermore expresses HF severity. But HCVR direct correlation with HF to predict HF severity has not been sufficiently studied yet. Methods and results We included 501 HF patients that received multichannel cardiorespiratory polygraphy, clinical workup for HF and HCVR in our center. The degree of SDB was graded with apnea-hypopnea-index (AHI) with guideline recommendation for treatment at an AHI >15/h. NT-Pro-BNP was obtained for HF quantification. Mean age was 66.4±11 years, body mass index (BMI) 30.7±5 kg/m2 and mean HCVR was 2.56±1.18. 136 (27.2%) patients had central SDB with a proportion of 124 (24.8%) having moderate to severe SDB (AHI >15/h). 345 (68.9%) had obstructive SDB with moderate to severe SDB in 296 (59.1%) patients. Differences were detected for HCVR and HF in the central SDB group with a HCVR of 2.78±1.4 and NT-Pro-BNP of 2835.88±10536.4 pg/ml, while the OSA group shows a HCVR of 2.5±1 and NT-Pro-BNP of 929.9±1781. Linear regression identified HCVR (p=0.045) and NT-Pro-BNP (p=0.034) to independently correlate with central SDB and in addition HCVR was also significantly associated with NT-Pro-BNP (p=0.007). Conclusion HF severity is closely linked to both NT-Pro-BNP and central SDB. HCVR seems to have the potential to predict manifestation of central SDB and increased NT-Pro-BNP values in HF. HCVR may be an easily obtainable parameter to identify both HF severity and presence of central SDB in HF patients. Funding Acknowledgement Type of funding source: None

scholarly journals Evaluation of the Apnea-Hypopnea Index Determined by Adaptive Servo-Ventilation Devices in Patients With Heart Failure and Sleep-Disordered Breathing

2021 ◽  
Vol 8 ◽  
Author(s):  
Satomi Imanari ◽  
Yasuhiro Tomita ◽  
Satoshi Kasagi ◽  
Fusae Kawana ◽  
Yuka Kimura ◽  
...  
Keyword(s):  
Heart Failure ◽  
Sleep Disordered Breathing ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Apnea Hypopnea Index ◽  
Adaptive Servo Ventilation ◽  
Respiratory Events ◽  
Patients With Heart Failure ◽  
Modest Correlation ◽  
Disordered Breathing

Introduction: Adaptive servo-ventilation (ASV) devices are designed to suppress central respiratory events, and therefore effective for sleep-disordered breathing (SDB) in patients with heart failure (HF) and provide information about their residual respiratory events. However, whether the apnea-hypopnea index (AHI), determined by the ASV device AutoSet CS (ASC), correlates with the AHI calculated by polysomnography (PSG) in patients with HF and SDB remains to be evaluated.Methods: Consecutive patients with SDB titrated on ASC were included in the study. We assessed the correlation between AHI determined by manual scoring during PSG (AHI-PSG) and that determined by the ASC device (AHI-ASC) during an overnight session.Results: Thirty patients with HF and SDB (age, 68.8 ± 15.4 years; two women; left ventricular ejection fraction, 53.8 ± 17.9%) were included. The median AHI in the diagnostic study was 28.4 events/h, including both obstructive and central respiratory events. During the titration, ASC markedly suppressed the respiratory events (AHI-PSG, 3.3 events/h), while the median AHI-ASC was 12.8 events/h. We identified a modest correlation between AHI-PSG and AHI-ASC (r = 0.36, p = 0.048). The Brand-Altman plot indicated that the ASC device overestimated the AHI, and a moderate agreement was observed with PSG.Conclusions: There was only a modest correlation between AHI-PSG and AHI-ASC. The discrepancy may be explained by either the central respiratory events that occur during wakefulness or the other differences between PSG and ASC in the detected respiratory events. Therefore, clinicians should consider this divergence when assessing residual respiratory events using ASC.

scholarly journals Association Between Sleep Disordered Breathing and Left Ventricular Function

2020 ◽  
Vol 13 (5) ◽  
Author(s):  
Rachel P. Ogilvie ◽  
Michael V. Genuardi ◽  
Jared W. Magnani ◽  
Susan Redline ◽  
Martha L. Daviglus ◽  
...  
Keyword(s):  
Heart Failure ◽  
Diastolic Dysfunction ◽  
Sleep Disordered Breathing ◽  
Survey Design ◽  
Systolic Function ◽  
Epidemiological Studies ◽  
Left Ventricular ◽  
Health Study ◽  
Apnea Hypopnea Index ◽  
Disordered Breathing

Background: Prior studies have found that sleep-disordered breathing (SDB) is common among those with left ventricular (LV) dysfunction and heart failure. Few epidemiological studies have examined this association, especially in US Hispanic/Latinos, who may be at elevated risk of SDB and heart failure. Methods: We examined associations between SDB and LV diastolic and systolic function using data from 1506 adults aged 18 to 64 years in the Hispanic Community Health Study/Study of Latinos ECHO-SOL Ancillary Study (2011–2014). Home sleep testing was used to measure the apnea-hypopnea index, a measure of SDB severity. Echocardiography was performed a median of 2.1 years later to quantify LV diastolic function, systolic function, and structure. Multivariable linear regression was used to model the association between apnea-hypopnea index and echocardiographic measures while accounting for the complex survey design, demographics, body mass, and time between sleep and echocardiographic measurements. Results: Each 10-unit increase in apnea-hypopnea index was associated with 0.2 (95% CI, 0.1–0.3) lower E′, 0.3 (0.1–0.5) greater E/E′ ratio, and 1.07-fold (1.03–1.11) higher prevalence of diastolic dysfunction as well as 1.3 (0.3–2.4) g/m 2 greater LV mass index. These associations persisted after adjustment for hypertension and diabetes mellitus. In contrast, no association was identified between SDB severity and subclinical markers of LV systolic function. Conclusions: Greater SDB severity was associated with LV hypertrophy and subclinical markers of LV diastolic dysfunction. These findings suggest SDB in Hispanic/Latino men and women may contribute to the burden of heart failure in this population.

scholarly journals A Long-Term Prognosis of Adaptive Servo Ventilation Therapy for Patients with Heart Failure -Consideration in Severity of Sleep-Disordered Breathing-

2016 ◽  
Vol 1 ◽  
Author(s):  
Keita Goto ◽  
Noriaki Takama ◽  
Masahiko Kurabayashi
Keyword(s):  
Heart Failure ◽  
Cardiovascular Events ◽  
Sleep Disordered Breathing ◽  
Study Groups ◽  
Good Prognosis ◽  
Apnea Hypopnea Index ◽  
Adaptive Servo Ventilation ◽  
Long Term Prognosis ◽  
Disordered Breathing

<p><strong>Background:</strong> Adaptive servo-ventilation (ASV) is used to treat sleep apnea in heart failure (HF). However, it is unclear whether ASV improves the long-term prognosis for all patients with HF, regardless of the severity of sleep-disordered breathing (SDB). We therefore aimed to estimate the long-term prognosis associated with ASV therapy for patients with HF by the severity of SDB.</p><p><strong>Methods:</strong> Sixty-one consecutive patients with HF (mean age ± standard deviation: 70 ± 10 years) were initiated on ASV therapy for HF treatment after polysomnography. Patients were then classified into the following three groups based on their apnea–hypopnea index (AHI): a severe group with an AHI of ≥40/h (n = 28); a moderate group with an AHI of ≥20/h but &lt;40/h (n = 20); and a mild group with an AHI of &lt;20/h (n = 13). To estimate long-term prognosis, we reviewed the 3-year follow-up data, including that concerning fatal cardiovascular events (death from myocardial infarction, cardioembolic stroke, and fatal cardiac arrhythmias).</p><p><strong>Results:</strong> No significant differences were observed between the three study groups in the risk of fatal cardiovascular events (p = 0.207).<strong></strong></p><p><strong>Conclusions:</strong> Our results suggest that ASV therapy is associated with a good prognosis and that ASV therapy is effective, regardless of the severity of SDB.</p><p> </p>

Short-term use of adaptive servo ventilation improves renal function in heart failure patients with sleep-disordered breathing

2012 ◽  
Vol 28 (6) ◽  
pp. 728-734 ◽  
Author(s):  
Akiomi Yoshihisa ◽  
Satoshi Suzuki ◽  
Takashi Owada ◽  
Shoji Iwaya ◽  
Hiroyuki Yamauchi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Sleep Disordered Breathing ◽  
Short Term ◽  
Adaptive Servo Ventilation ◽  
Heart Failure Patients ◽  
Disordered Breathing

Increased risk of heart failure in women with symptoms of sleep-disordered breathing

2016 ◽  
Vol 17 ◽  
pp. 32-37 ◽  
Author(s):  
Mirjam Ljunggren ◽  
Liisa Byberg ◽  
Jenny Theorell-Haglöw ◽  
Bertil Lindahl ◽  
Karl Michaëlsson ◽  
...  
Keyword(s):  
Heart Failure ◽  
Sleep Disordered Breathing ◽  
Increased Risk ◽  
Disordered Breathing
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