Prevalence of central sleep apnea among heart failure patients with preserved ejection fraction

Abstract

Introduction Central sleep apnea (CSA) is common among patients with chronic heart failure (CHF) and has been associated with increased morbidity and mortality. However, scarce data about CSA prevalence in heart failure patients with preserved ejection fraction (EF) are available. The aim of the study was to determine the prevalence of CSA among ambulatory heart failure patients with preserved ejection fraction (HFPEF). Materials and methods Thirty-three ambulatory patients with HFPEF were recruited and subjected to full-night polysomnography. The presence of sleep-disordered breathing (SDB) was based on apnea-hypopnea index (AHI) – 5–15 – mild, 15–30 – moderate, >30 – severe. Preserved ejection fraction was defined as EF > 45%. All patients received drug treatment in concordance with the latest guidelines. Results The mean age was 65.8 ± 8.5 years and the mean left ventricular ejection fraction was 55.4 ± 6.4%. Among the 33 patients, 27 (81.8%) had SDB – 11 (33.3%) CSA, 4 (12.1%) obstructive sleep apnea and 12 (36.4%) mixed sleep apnea. Moderate or severe SDB was present in 24 of them (72.3%). No statistically significant differences between CHF patients with CSA and CHF patients without SDB were found regarding main anthropometric parameters (body-mass index (BMI) = 28.5 ± 6.9 vs 25.6 ± 8.7, NS, age = 70.2 ± 9.9 vs 63.3 ± 8.1, NS) and excessive daytime sleepiness (Epworth score = 8.7 ± 6.1 vs 7.2 ± 2.6). Conclusion CSA demonstrates very high prevalence in patients with HFPEF. Those patients should also be considered for screening for SDB and consequent therapy. Acknowledgement The study was financed by the Bulgarian Ministry of Youth and Science.