Author + information
- Olaf Oldenburg,
- Anke Tueroff,
- Ulrich Thiem,
- Henrik Fox,
- Jens Spiesshoefer,
- Thomas Bitter,
- Renaud Tamisier,
- Naresh Punjabi and
- Dieter Horstkotte
Background: Sleep-disordered breathing (SDB) is highly prevalent in patients with heart failure and reduced left ventricular ejection fraction (HF-REF). SDB is classified as being predominant obstructive (OSA) or central (CSA) and may alter sleep duration, sleep quality and quality of life. Sleep duration and sleep quality have been shown to influence survival. However, few studies describe sleep quality and duration in well-characterized cohorts of HF patients.
Methods: 250 consecutive patients with HF-REF (NYHA class ≥II, ejection fraction ≤45%) underwent cardiac and pulmonary examination, plus full attended in-hospital overnight polysomnography (PSG). PSG recordings were performed according to current recommendations, and underwent independent, blinded analysis at a core laboratory.
Results: Patients with HF-REF and CSA spent more time in bed than those with OSA (468±52 vs 454±46 min, p=0.021), but had lower sleep efficiency (67±14 vs 72±13% of total sleep time [TST], p=0.008). HF-REF patients with CSA versus OSA had more wake time after sleep onset (101±61 vs 71±46 min, p=0.001) and more stage N1 sleep (33±19 vs 28±16% of TST, p=0.017). Overall, the proportion of sleep spent in N3 in HF-REF patients with SDB was low (4.1±6.3% of TST).
Conclusions: This trial in a large cohort of HF-REF patients with OSA and CSA found worse sleep efficiency and quality in those with CSA versus OSA. This could result in less restorative sleep, changes in sympatho-vagal balance, and impaired resetting of important reflexes, which could combine to contribute to worse cardiovascular outcomes in HF-REF patients with SDB.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: The Evolving World of LVADs, Transplant and Other Novel Discoveries
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1294-279
- 2017 American College of Cardiology Foundation