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01-12-2013 | Original Paper

Sleep-disordered breathing in patients undergoing transfemoral aortic valve implantation for severe aortic stenosis

Authors: Zisis Dimitriadis, Marcus Wiemer, Werner Scholtz, Lothar Faber, Cornelia Piper, Thomas Bitter, Ippokratis Messaritakis, Kevin Bullert, Jochen Boergermann, Georg Kleikamp, Christian Prinz, Dieter Horstkotte, Olaf Oldenburg

Published in: Clinical Research in Cardiology | Issue 12/2013

Abstract

Background

We examined the prevalence of sleep-disordered breathing (SDB) in patients with severe aortic valve stenosis (AS) and the impact of transfemoral aortic valve implantation (TAVI) on SDB.

Methods

79 patients underwent cardiorespiratory polygraphy (PG) before TAVI (CoreValve™), 62 of them a second PG after the procedure.

Results

Forty-nine (62 %) patients had obstructive sleep apnea (OSA), 25 (32 %) central sleep apnea (CSA), and 5 (6 %) presented without significant SDB (apnea–hypopnea index (AHI) < 5/h). Among the 62 patients evaluated before and after TAVI, 36 (58 %) had OSA, 22 (36 %) CSA, and 4 patients (7 %) no SDB. AHI was significantly higher in CSA patients than in OSA patients (34.5 ± 18.3 vs. 18.0 ± 12.6/h, p < 0.001). Successful TAVI had a significant impact on CSA but not on OSA: CSA patients with optimal TAVI results experienced a significant reduction in central respiratory events (AHI 39.6 ± 19.6–23.1 ± 16.0/h, p = 0.035), while no changes were detected in OSA patients (AHI 18.8 ± 13.0–20.25 ± 13.4/h, p = 0.376). In contrast, in patients who developed at least moderate periprosthetic aortic regurgitation (AR > I), CSA increased significantly (AHI 26.3 ± 13.2–39.2 ± 18.4/h, p = 0.036), whereas no acute change was seen in patients with OSA (AHI 10.5 ± 7.8–12.5 ± 5.0/h, p = 0.5).

Conclusion

OSA and CSA are prevalent in more than 90 % of patients undergoing TAVI for severe aortic valve stenosis. Successful TAVI had no significant impact on OSA but improved CSA. In case of an acute change from pressure overload (aortic stenosis) to acute volume overload (aortic regurgitation after TAVI), central, but not obstructive, sleep apnea deteriorated.

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Title: Sleep-disordered breathing in patients undergoing transfemoral aortic valve implantation for severe aortic stenosis
Authors: Zisis Dimitriadis
Marcus Wiemer
Werner Scholtz
Lothar Faber
Cornelia Piper
Thomas Bitter
Ippokratis Messaritakis
Kevin Bullert
Jochen Boergermann
Georg Kleikamp
Christian Prinz
Dieter Horstkotte
Olaf Oldenburg
Publication date: 01-12-2013
Publisher: Springer Berlin Heidelberg
Published in: Clinical Research in Cardiology / Issue 12/2013
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-013-0603-0

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Sleep-disordered breathing in patients undergoing transfemoral aortic valve implantation for severe aortic stenosis

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Methods

Results

Conclusion

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