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Published in: Clinical Research in Cardiology 7/2013

01-07-2013 | Original Paper

Portable recording for detecting sleep disorder breathing in patients under the care of a heart failure clinic

Authors: Peter Dolliner, Lindsay Brammen, Senta Graf, Martin Huelsmann, Leopold Stiebellehner, Andreas Gleiss, Philipp Ubl, Guenter Steurer

Published in: Clinical Research in Cardiology | Issue 7/2013

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Abstract

Background

Sleep disordered breathing (SDB) has important clinical implications in patients with congestive heart failure (CHF). We performed portable recording in unselected CHF patients on contemporary therapy. Data on the interactions of SDB in patients supervised at heart failure clinics are rare and we illustrate diversities of obstructive sleep apnoea (OSA) and central sleep apnoea (CSA).

Methods

We studied 176 consecutive subjects on contemporary medical therapy with a median left ventricular ejection fraction of 25.0 % (range 7–35 %) and median NT-pro BNP levels of 3,413.0 pg/ml (range 305.1–35,000.0 pg/ml). Participants underwent prospective overnight portable recording.

Results

50 % presented with an at least moderate form of nocturnal breathing disorder [apnoea–hypopnoea index (AHI) ≥15/h]. Only 15 patients (17.1 %) with AHI ≥15/h reported excessive daytime sleepiness. Irrespective of left ventricular ejection fraction, patients with CSA had higher levels of NT-pro BNP compared to patients with OSA (differences in medians = 2,639.0 pg/ml, p = 0.016), and compared to patients with an AHI <15/h (differences in medians = 2,710.0 pg/ml, p < 0.001). OSA affected 26 patients (14.8 %).

Conclusions

Patients with severe stable CHF on contemporary therapy have a prevalence of 50.0 % of moderate to severe SDB. The natural cascade of the failing heart is initially characterised by absent SDB or OSA, whereas end-stage CHF is associated with CSA.
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Metadata
Title
Portable recording for detecting sleep disorder breathing in patients under the care of a heart failure clinic
Authors
Peter Dolliner
Lindsay Brammen
Senta Graf
Martin Huelsmann
Leopold Stiebellehner
Andreas Gleiss
Philipp Ubl
Guenter Steurer
Publication date
01-07-2013
Publisher
Springer Berlin Heidelberg
Published in
Clinical Research in Cardiology / Issue 7/2013
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI
https://doi.org/10.1007/s00392-013-0563-4

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