Prevalence and characteristics of sleep apnoea in patients with stable heart failure: Results from a heart failure clinic

BMC Pulmonary Medicine

Research Article

Susana Ferreira¹  Paulo Bettencourt¹  Marta Patacho¹  Elisabete Santa-Clara²  Cristina Carrondo²  João Winck²  Anabela Marinho² 

[1] Internal Medicine Department, São João Hospital, Oporto Medical University, Cardiovascular Research Unit, Alameda Professor Doutor Hernâni Monteiro, 4200-319, Porto, Portugal;Pneumology Department, São João Hospital, Oporto Medical University, Cardiovascular Research Unit, Alameda Professor Doutor Hernâni Monteiro, 4200-319, Porto, Portugal;

关键词: Heart Failure Patient;    Epworth Sleepiness Scale;    Obstructive Sleep Apnoea;    Neck Circumference;    Heart Failure Therapy;   

DOI  :  10.1186/1471-2466-10-9

 received in 2009-07-18, accepted in 2010-03-03,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundHeart failure (HF) and sleep apnoea (SA) association has been recognized but whether it results from confounding factors (hypertension, ischaemia, obesity) remains unclear.We aimed to determine the prevalence of SA in HF and to identify potential risk factors for SA in HF population.MethodsWe prospectively evaluated 103 patients with stable HF on optimized therapy. In-laboratory polysomnography was performed. Type and severity of SA were defined according international criteria. Demographic, anthropometric and clinical characteristics were collected. Continuous data are expressed as median and interquartile range.ResultsSA was found in 72.8%, moderate to severe in a significant proportion (apnoea-hypopnoea index ≥ 15- 44.7% of all patients) and predominantly obstructive (60.0% of patients with SA). Most patients were non-sleepy (Epworth < 10- 66%). SA patients were predominantly men (85.3 vs 60.7%, p-0.015), had larger neck (38.0 (35.0-42.0) vs 35.0 (33.2-38.0) cm, p-0.003), severe systolic dysfunction, (63.9 vs 33.3%, p-0.018), left ventricle (LV) hypertrophy (16.2 vs 0.0%, p-0.03), LV and left atria (LA) dilatation (49.0 (44.0-52.0) vs 42.0 (38.0-48.0) mm, p < 0.001; 60.0 (54.0-65.0) vs 56.0 (52.0-59.0) mm, p-0.01). However, only LA diameter was an independent predictor of SA. Higher body-mass index (BMI) was associated with moderate to severe SA. Patients with obstructive SA had larger neck and a trend for higher BMI, snoring and sleepiness. Hypocapnia was not associated with central SA.ConclusionsIn our HF population, SA was prevalent, frequently asymptomatic and without characteristic risk factors. Unlike previously reported, obstructive SA was the predominant type. These results suggest that SA is underdiagnosed in HF and there is a possible correlation between them, independent of confounding factors. Recent advances in HF therapy might influence prevalence and type of SA in this population.

【 授权许可】

CC BY   
© Ferreira et al; licensee BioMed Central Ltd. 2010