Abstract 18611: Transcatheter Aortic Valve Implantation Reduces Central Sleep Apnea in Patients with Severe Aortic Stenosis

Abstract

Introduction While the association between congestive heart failure and central sleep apnea (CSA) is well described, the role of sleep disordered breathing (SDB) and particularly CSA in valvular heart disease is unclear. We evaluated 67 patients with high-grade aortic stenosis and high preoperative risk for the prevalence of SDB before and after transcatheter aortic valve implantation (TAVI). Methods 67 consecutive patients that were eligible for TAVI were underwent an overnight polygraphy (Embletta ® Device, Embla). Clinical, echocardiographic and invasive data were collected. SDB was defined as an apnea-hypopnea-index (AHI) >5/h. In 31 patients that to date performed the 3 months follow-up, monitoring was repeated and compared to the baseline status. Results Prevalence of SDB was 61% with a clear predominance of CSA (43%, table 1). In the 3 months follow-up that was completed by 31 patients so far, significant improvement in AHI, AI central, LVEF, NYHA class and NT pro-BNP was seen (table 2). There was a highly significant inverse correlation of NT pro-BNP with LVEF (r=-0.72, p<0.001) but not with severity of CSA (r=0.19, p=0.13). 18 patients died before the 3 months follow-up. Conclusion We can show a high prevalence of SDB, in particular of CSA, in this patient cohort. There is a highly significant improvement of sleep apnea in the CSA subgroup after TAVI, which is independent of left ventricular function and NT pro-BNP.