Prediction of Death and Hospital Admissions Via Innovative Detection of Cheyne-Stokes Breathing in Heart Failure Patients

Abstract

Cheyne-Stokes breathing (CSB) has been associated with advanced heart failure for two centuries. However, the current conventional method of CSB detection is via a full-night polysomnographic test which is a complex, expensive and inconvenient for the patients. Accordingly, the purpose of the current study was to assess a more practical method for CSB detection in heart failure (HF) patients and investigate its prognostic applications. We describe here risk stratification for mortality and morbidity over 6 months of follow-up by using standard pulse oximeter analyzed with an innovative automated program for CSB detection. A total of 109 consecutive HF out-patients, 93 men and 16 women underwent a full-night sleep studies performed at home, using a standard pulse oximeter for detection of CSB during sleep. Data was analyzed by an innovative algorithm-based system. Of the 109 patients, our analysis identified 46 (42%) patients with episodes of CSB. Within the 6-month follow-up period, 8 (17.4%) of these patients died or were urgently transplanted, and 14 (30.4%) were hospitalized for HF. Multiple regression testing with several known prognostic parameters, showed that CSB was the most significant predictor of mortality or heart failure hospitalizations (p < 0.001). Heart failure patients with CSB have increased mortality and morbidity over the next 6 months. The detection of CSB is feasible via a simple and reliable method using a standard pulse oximeter, which may be more suitable for sick HF patients than the complex and inconvenient full-night polysomnography.