Abstract 5919: Clinical Features and Prognosis of Heart Failure Patients Complicated with Predominant Central Sleep Apnea
Background: Several studies have reported that the presence of sleep apnea (SA) is associated with a poor prognosis in heart failure (HF) patients. In HF patients, obstructive SA (OSA) and central SA (CSA) are often coexisted and in gerenal, more numbers of central respiratory events may occur in severer HF. However, there were few data comparing prognosis of predominant CSA patients to the others.
Methods: Between 2001 and 2005, patients were enrolled if they met the following criteria:
the presence of HF (LVEF ≤50% and NYHA class ≥II;
stable clinical status;
having undergone full sleep study and diagnosed as significant SA (apnea-hypopnea index [AHI] ≥15/h).
Patients were classified into 2 groups according to the percent of central per total respiratory events (%C/T) < or ≥ median level. The characteristics and the incidence of clinical events (composite of death and hospitalization) were compared.
Results: Overall, 144 patients were enrolled. The median level of the %C/T was 30.1%. Patients with predominant CSA (%C/T ≥30.1%) revealed significantly higher AHI, higher BNP, greater NYHA class, and were more frequently complicated with atrial fibrillation (Af). During 23.4±16 months, the events rate was 45.8%. Multivariate analysis showed that the risk for the clinical events was increased in the predominant CSA group (HR 2.30, P<0.01) in addition to the reduced LVEF, elevated BNP, lower blood pressure, presence of Af and absence of beta blocker use. Even if the %C/T was included as a continuous variable, greater %C/T was associated with the risk of the clinical events.
Conclusions: HF patients complicated with predominant CSA revealed higher risk for death and hospitalization.