Characterization of sleep disordered breathing in a group of 123 heart failure patients

Abstract

Introduction The main objective of this study was to describe characteristics of Sleep Disordered Breathing (SDB) in a group of heart failure patients with varying degrees of left ventricular dysfunction. Method A ventilatory polygraphy was systematically performed on 123 patients with either systolic heart failure (LVEF 45%, n=82 patients) regardless of the presence of symptoms suggestive of SDB. Sleep apnea syndrome (SAS) was defined by an apnea-hyponea index (AHI)>5/h. SAS was considered severe for AHI above 30/h. Results Patients were 60 ± 13 years old with a male predominance (sex ratio 3:1). Average LVEF was 27.2 % in the subgroup of systolic heart failure patients versus 54.9 % in patients with diastolic dysfunction. The prevalence of SAS in the whole population was 78% (n=96) and 40 patients (41%) had severe SAS. 58% of SAS were obstructive and 42% central. The highest prevalence of SAS (93% n=38/41) was observed in the subgroup of systolic heart failure with 53% of obstructive SAS and 47% of central SAS. In the subgroup of diastolic heart failure patients, prevalence of SAS was 69.5% (n=57/82) with 61% of obstructive SAS and 38.6% of central SAS. Prevalence of the severe SAS was similar in each subgroup. Conclusion Prevalence of sleep apnea syndrome is high in heart failure patients whatever the level of LVEF. Obstructive Sleep apnea are predominant but the prevalence of central SAS increase in patients with systolic heart failure. Prevalence of SAS trend to be higher when systolic heart failure is present, however percentage of severe SAS is the same with or without systolic dysfunction.