on January 27, 2003
Published online before print January 27, 2003, doi: 10.1161/01.CIR.0000049641.11675.EE
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Submitted on September 18, 2002
From the Divisions of Cardiology (P.A.L., U.C., E.E., P.G.) and Pulmonary Disease (A.B.), Fondazione Salvatore Maugeri IRCCS, Veruno, Italy, and the Divisions of Cardiovascular Diseases and Hypertension, Mayo Clinic, Rochester, Minn (P.A.L., V.K.S.). * To whom correspondence should be addressed. E-mail: paola-lanfranchi{at}CRHSC.umontreal.ca.
Background--The prevalence and characteristics of sleep-disordered breathing in patients with asymptomatic left ventricular (LV) dysfunction are unknown. Therefore, we evaluated the prevalence of sleep-disordered breathing in patients with LV dysfunction without overt heart failure and tested the hypothesis that sleep-disordered breathing is linked to greater hemodynamic and autonomic impairment. Methods and Results--We studied 47 patients with LV ejection fractions Conclusions--CSA is highly prevalent in patients with asymptomatic LV dysfunction. The severity of CSA may not be related to the severity of hemodynamic impairment. Severe CSA is associated with impaired cardiac autonomic control and with increased cardiac arrhythmias.
Accepted on October 28, 2002
Central Sleep Apnea in Left Ventricular Dysfunction. Prevalence and Implications for Arrhythmic Risk
Paola A. Lanfranchi MD*,
40% without any history of heart failure. Central sleep apnea (CSA), as defined by an apnea-hypopnea index 
15/h, was present in 26 patients (55%), 17 (36%) of whom had severe CSA (apnea-hypopnea index 30/h). Obstructive sleep apnea was evident in 5 patients (11%). The prevalence and severity of CSA were higher in patients with ischemic cardiomyopathy than in patients with nonischemic cardiomyopathy (P<0.05). Exercise tolerance and echocardiographic indices of systolic and diastolic function were similar in patients without CSA, with mild CSA, and with severe CSA. Heart rate variability was markedly depressed in patients with CSA (P<0.05). Patients with severe CSA also had a higher incidence of nonsustained ventricular tachycardia (P=0.05).
Key words: sleep • nervous system, autonomic • tachyarrhythmias • heart failure
This article has been cited by other articles:
 |
|
 |
|
  J. D. Gottlieb, A. R. Schwartz, J. Marshall, P. Ouyang, L. Kern, V. Shetty, M. Trois, N. M. Punjabi, C. Brown, S. S. Najjar, et al. Hypoxia, not the frequency of sleep apnea, induces acute hemodynamic stress in patients with chronic heart failure. J. Am. Coll. Cardiol., October 27, 2009; 54(18): 1706 - 1712. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. L. Verrier and M. E. Josephson Impact of Sleep on Arrhythmogenesis Circ Arrhythm Electrophysiol, August 1, 2009; 2(4): 450 - 459. [Full Text] [PDF]
|
|
|
|
 |
|
 D Yumino, H Wang, J S Floras, G E Newton, S Mak, P Ruttanaumpawan, J D Parker, and T D Bradley Relationship between sleep apnoea and mortality in patients with ischaemic heart failure Heart, May 1, 2009; 95(10): 819 - 824. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Borgel and A. Mugge Central Sleep Apnea Induces Ventricular Bigeminus: Conclusions From a Single Polygraphy Circulation, September 23, 2008; 118(13): 1398 - 1401. [Full Text] [PDF]
|
|
|
|
|
|
V. K. Somers, D. P. White, R. Amin, W. T. Abraham, F. Costa, A. Culebras, S. Daniels, J. S. Floras, C. E. Hunt, L. J. Olson, et al. Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement From the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health) Circulation, September 2, 2008; 118(10): 1080 - 1111. [Full Text] [PDF]
|
|
|
|
|
|
V. K. Somers, D. P. White, R. Amin, W. T. Abraham, F. Costa, A. Culebras, S. Daniels, J. S. Floras, C. E. Hunt, L. J. Olson, et al. Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement From the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health) J. Am. Coll. Cardiol., August 19, 2008; 52(8): 686 - 717. [Full Text] [PDF]
|
|
|
|
 |
|
 A. Garcia-Touchard, V. K. Somers, L. J. Olson, and S. M. Caples Central Sleep Apnea: Implications for Congestive Heart Failure Chest, June 1, 2008; 133(6): 1495 - 1504. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. Oldenburg, A. Schmidt, B. Lamp, T. Bitter, B. G. Muntean, C. Langer, and D. Horstkotte Adaptive servoventilation improves cardiac function in patients with chronic heart failure and Cheyne-Stokes respiration Eur J Heart Fail, June 1, 2008; 10(6): 581 - 586. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M. Ryan, S. Juvet, R. Leung, and T. D. Bradley Timing of Nocturnal Ventricular Ectopy in Heart Failure Patients With Sleep Apnea Chest, April 1, 2008; 133(4): 934 - 940. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Kasai, K. Narui, T. Dohi, N. Yanagisawa, S. Ishiwata, M. Ohno, T. Yamaguchi, and S.-i. Momomura Prognosis of Patients With Heart Failure and Obstructive Sleep Apnea Treated With Continuous Positive Airway Pressure Chest, March 1, 2008; 133(3): 690 - 696. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Yumino and T. D. Bradley Central Sleep Apnea and Cheyne-Stokes Respiration Proceedings of the ATS, February 15, 2008; 5(2): 226 - 236. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Brack, I. Thuer, C. F. Clarenbach, O. Senn, G. Noll, E. W. Russi, and K. E. Bloch Daytime Cheyne-Stokes Respiration in Ambulatory Patients With Severe Congestive Heart Failure Is Associated With Increased Mortality Chest, November 1, 2007; 132(5): 1463 - 1471. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Oldenburg, L. Faber, J. Vogt, A. Dorszewski, F. Szabados, D. Horstkotte, and B. Lamp Influence of cardiac resynchronisation therapy on different types of sleep disordered breathing Eur J Heart Fail, August 1, 2007; 9(8): 820 - 826. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Javaheri, R. Shukla, H. Zeigler, and L. Wexler Central Sleep Apnea, Right Ventricular Dysfunction, and Low Diastolic Blood Pressure Are Predictors of Mortality in Systolic Heart Failure J. Am. Coll. Cardiol., May 22, 2007; 49(20): 2028 - 2034. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Garrigue, J.-L. Pepin, P. Defaye, F. Murgatroyd, Y. Poezevara, J. Clementy, and P. Levy High Prevalence of Sleep Apnea Syndrome in Patients With Long-Term Pacing: The European Multicenter Polysomnographic Study Circulation, April 3, 2007; 115(13): 1703 - 1709. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Vazir, P.C. Hastings, M. Dayer, H.F. McIntyre, M.Y. Henein, P.A. Poole-Wilson, M.R. Cowie, M.J. Morrell, and A.K. Simonds A high prevalence of sleep disordered breathing in men with mild symptomatic chronic heart failure due to left ventricular systolic dysfunction Eur J Heart Fail, March 1, 2007; 9(3): 243 - 250. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Oldenburg, B. Lamp, L. Faber, H. Teschler, D. Horstkotte, and V. Topfer Sleep-disordered breathing in patients with symptomatic heart failure A contemporary study of prevalence in and characteristics of 700 patients Eur J Heart Fail, March 1, 2007; 9(3): 251 - 257. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Ferreira, J. Winck, P. Bettencourt, and F. Rocha-Goncalves Heart failure and sleep apnoea: To sleep perchance to dream Eur J Heart Fail, May 1, 2006; 8(3): 227 - 236. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. M. Caples, R. Wolk, and V. K. Somers Influence of cardiac function and failure on sleep-disordered breathing: evidence for a causative role J Appl Physiol, December 1, 2005; 99(6): 2433 - 2439. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A D Staniforth, S C Sporton, M J Early, J A Wedzicha, A W Nathan, and R J Schilling Ventricular arrhythmia, Cheyne-Stokes respiration, and death: observations from patients with defibrillators Heart, November 1, 2005; 91(11): 1418 - 1422. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L J Cormican and A Williams Sleep disordered breathing and its treatment in congestive heart failure Heart, October 1, 2005; 91(10): 1265 - 1270. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Skobel, C. Norra, A. Sinha, C. Breuer, P. Hanrath, and C. Stellbrink Impact of sleep-related breathing disorders on health-related quality of life in patients with chronic heart failure Eur J Heart Fail, June 1, 2005; 7(4): 505 - 511. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Series, R. J. Kimoff, D. Morrison, M. H. Leblanc, M. Smilovitch, J. Howlett, A. G. Logan, J. S. Floras, and T. D. Bradley Prospective Evaluation of Nocturnal Oximetry for Detection of Sleep-Related Breathing Disturbances in Patients With Chronic Heart Failure Chest, May 1, 2005; 127(5): 1507 - 1514. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Nopmaneejumruslers, Y. Kaneko, V. Hajek, V. Zivanovic, and T. D. Bradley Cheyne-Stokes Respiration in Stroke: Relationship to Hypocapnia and Occult Cardiac Dysfunction Am. J. Respir. Crit. Care Med., May 1, 2005; 171(9): 1048 - 1052. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Chen and F. M. Kusumoto QT Dispersion: Much Ado About Something? Chest, June 1, 2004; 125(6): 1974 - 1977. [Full Text] [PDF]
|
|
|
|
|
|
S. F. Quan and B. J. Gersh Cardiovascular Consequences of Sleep-Disordered Breathing: Past, Present and Future: Report of a Workshop From the National Center on Sleep Disorders Research and the National Heart, Lung, and Blood Institute Circulation, March 2, 2004; 109(8): 951 - 957. [Full Text] [PDF]
|
|
|
|
 |
|
 A. S. M. Shamsuzzaman, B. J. Gersh, and V. K. Somers Obstructive Sleep Apnea: Implications for Cardiac and Vascular Disease JAMA, October 8, 2003; 290(14): 1906 - 1914. [Abstract] [Full Text] [PDF]
|
|