Abstract 14946: The Complication of Both Sleep-Disordered Breathing and Chronic Kidney Disease are Associated With Poor Prognosis in Patients With Idiopathic Dilated Cardiomyopathy
Background: Sleep-disordered breathing (SDB) is associated with activation of the sympathetic nervous system, whereas chronic kidney disease (CKD) is related to impairment of the renin-angiotensin-aldosterone system. Little information is available on the relation of these conditions to heart failure. We have investigated that both SDB and CKD are associated with poor prognosis in patients with idiopathic dilated cardiomyopathy (IDCM).
Methods: A total of 133 consecutive patients with IDCM was screened for SDB, evaluated for estimated glomerular filtration rate (eGFR), and subjected to cardiac catheterization for measurement of left ventricular (LV) pressure with a micromanometer. The maximal first derivative of LV pressure (LV dP/dtmax) and the pressure half-time (T1/2) were determined as indexes of contractility and LV isovolumic relaxation, respectively. All patients were followed up for identification of cardiac events for a mean of 3.5 years.
Results: The mean age, LV ejection fraction, and plasma brain natriuretic peptide (BNP) level were 52 years, 39%, and 166 pg mL-1, respectively. Patients were classified into four groups on the basis of apnea-hypopnea index (AHI) and eGFR: AHI < 15 h-1 and eGFR ≥ 60 mL min-1 1.73 m-2 (n = 58, group A), AHI ≥15 and eGFR ≥ 60 (n = 30, group B), AHI < 15 and eGFR < 60 (n = 23, group C), and AHI ≥15 and eGFR < 60 (n = 22, group D). There were no significant differences in LV dP/dtmax and T1/2 among the four groups. However, the probability of event-free survival in the group D was lower than that in the other groups (P = 0.006, Figure).
Conclusions: The complication of both SDB and CKD may be associated with cardiac events in patients with IDCM.
- © 2010 by American Heart Association, Inc.