Author + information
To study short- and long-term effects of nocturnal oxygen therapy (NOT) on sleep apnea in chronic heart failure (CHF).
In 51 consecutive stable CHF patients, NYHA II/III, left ventricular ejection fraction (LVEF) ≤ 45%, baseline nocturnal ventilation polygraphy identified 33 sleep apnea patients (apnea-hypopnea index (AHI) ≥ 15 events/h) who were randomized to receive NOT 3 L/min (n=19) or no NOT (n=14). NOT was applied for six months with a home concentrator, the first night with polygraphy. Sixteen NOT patients and 14 no-NOT patients were subjected to polygraphy after six months.
In no-NOT patients, there was no significant difference between baseline and the sixth month findings. In NOT patients, a marked AHI reduction was observed between baseline versus the first night, and the sixth month, respectively, 36.8±2.6 versus 20.8±3.0, and 18.3±2.4 events/h (p<0.0001) and, related to a central AHI decrease, respectively, 23.3±2.8 versus 8.3±1.6 and 6.1±1.4 events/h (p<0.0001). The oxygen desaturation index (ODI) evolved similarly: 33.0±5.2 versus 7.5±0.5 and 9.3±2.6 events/h (p<0.0001). NOT had no effects on obstructive and mixed AHI. In NOT patients versus no-NOT patients, respectively, AHI decreased by 49.0%±6.0% versus increased by 2.0%±14.0% (p<0.0001), ODI decreased by 59.0%±9.4% versus 6.4%±14.7% (p=0.004), arterial oxyhemoglobin saturation < 90% time decreased by 61.4%±9.9% versus increased by 60.0%±68.4% (p=0.07) and LVEF increased by 14.5%±10.2% versus 5.6%±16.1% (p=0.64).
In CHF patients with sleep apnea, NOT significantly reduced central AHI and ODI, with acute effects being sustained over time, without, however, impacting obstructive and mixed AHI nor daytime LVEF.
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Heart Failure: Therapeutic Insights
Abstract Category: 17. Heart Failure: Therapy
Presentation Number: 1306-276
- 2013 American College of Cardiology Foundation