Prognostic Importance of Novel Oxygen Desaturation Metrics in Patients With Heart Failure and Central Sleep Apnea.
J Card Fail
; 23(2): 131-137, 2017 Feb.
Article
en En
| MEDLINE
| ID: mdl-27615064
ABSTRACT
BACKGROUND:
Sleep-disordered breathing, particularly central sleep apnea (CSA), is highly prevalent in heart failure (HF) and an independent prognostic marker. We assessed the hypothesis that an increased hypoxemic burden during sleep may have greater prognostic value than the frequency of apneic and hypopneic episodes. METHODS ANDRESULTS:
We prospectively conducted overnight cardiorespiratory polygraphy on consecutive HF patients referred to our hospital from 2008 to 2011. We studied CSA defined by an apnea-hypopnea index (AHI) of ≥5 events/h with >75% of all events being central in origin. We determined the AHI, proportion of the sleep time with SpO2 <90% (T90%), and proportion of the recording time that 4% desaturation events occurred (4%POD). We studied 112 HF patients with either systolic or diastolic dysfunction. During a follow-up period of 37 ± 25 months, 32 patients (29%) died. Nonsurvivors had a higher 4%POD compared with survivors (11 ± 6.4% vs 19 ± 13%; P = .001), but did not differ significantly from survivors regarding AHI and T90%. An adjusted logistic regression analysis revealed that the 4%POD was the best independent predictor of mortality.CONCLUSIONS:
The 4%POD, a novel metric for the nocturnal hypoxemic burden, is an independent prognostic marker in HF patients affected by CSA.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Consumo de Oxígeno
/
Causas de Muerte
/
Apnea Central del Sueño
/
Insuficiencia Cardíaca Diastólica
/
Insuficiencia Cardíaca Sistólica
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Card Fail
Asunto de la revista:
CARDIOLOGIA
Año:
2017
Tipo del documento:
Article