Abstract 12846: Sleep Quality and Cardiac Structure and Function in Individuals With Heart Failure With Preserved Ejection Fraction

Abstract

Introduction: Sleep disorders are associated with heart failure. The association of cardiac dysfunction with abnormalities in sleep have not been clearly elucidated. We examined the association of cardiac structure and function on echo with sleep patterns in participants with stable heart failure with preserved ejection fraction (HFpEF). Hypothesis: Greater cardiac abnormalities would be associated with greater impairments in sleep quality in HFpEF. Methods: We recruited participants with compensated HFpEF. We used 14-day actigraphy to measure night-time sleep quality (latency, efficiency, awake after sleep onset, movement and fragmentation) and quantity (sleep duration). We examined cardiac structure: (left ventricular diastolic diameter [LVDD], volume [LVEDVI], left ventricular mass index [LVMI]); function (ejection fraction, global longitudinal strain [GLS], E/e’ ratio, E/A ratio, left atrial volume index, mitral annular velocity e’, tricuspid regurgitation velocity). Associations between sleep and echo parameters were examined using linear regression adjusted for age, sex, race and body mass index (BMI). Results: Among 47 study participants, 40% were Black, 72% were women, with mean age 65(11 SD) years. Cardiac abnormalities and sleep duration were not associated. Higher LVMI was associated with higher night fragmentation (ß coefficient and 95% confidence intervals 0.95 [0.16-1.74]). Higher average E/e’ was associated with higher night movement (2.62 [0.55-4.70]), and sleep fragmentation (2.61 [0.36-4.87]). Measures of systolic function were not associated with sleep abnormalities. Conclusions: In HFpEF, greater abnormalities in cardiac structure (LV mass) and diastolic function (higher E/e’) were associated with more restless sleep. Our findings suggest a relationship between sleep quality and cardiac dysfunction in patients with HFpEF. Future research is needed to assess the directionality of this association.