Atrial Fibrillation Was Associated with Sleep-Disordered Breathing in Heart Failure Patients

Abstract

Background: Sleep-disordered breathing (SDB) is frequently observed in heart failure patients. Central sleep apnea and Cheyne-Stokes respiration (CSR) have been reported predictors of mortality in systolic heart failure patients. However, little is known about association between atrial fibrillation and SDB in heart failure patients among Japanese population. Methods: Consecutive patients (n=45) with congestive heart failure admitted to our hospital between June 2009 and August 2010 were enrolled. SDB examination was performed using portable monitoring and polysomnography immediately before discharge after stabilizing heart failure by optimal pharmacological therapy. Those patients were classified into two groups according to apnea hypopnea index (AHI): L group (AHI 15). Clinical characteristics were compared between the groups. Results: Twenty-three (51%) patients were classified into L group (AHI=6.9±4.6) and 22 (49%) patients into H group (AHI=33.0±12.6). There was no significant difference in age, body mass index, medication (β-blocker, angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker, spironolactone), cardiac function and eGFR between the groups. Prevalence of atrial fibrillation (33% vs. 16%, p=0.025) and CSR (47% vs. 2%, p<0.001) and plasma BNP level (480±443 pg/ml vs. 246±262 pg/ml, p=0.035) were significantly higher in H than in L group. Conclusions: Japanese heart failure patients with SDB had higher prevalence of atrial fibrillation and CSR and higher plasma BNP level compared with the patients without SDB.