Abstract 16199: Sleep Disordered Breathing is an Independent Risk Factor for Left Atrial Enlargement in Patients With Congestive Heart Failure
Left atrial enlargement (LAE) is a predictor for adverse outcome in patients with congestive heart failure (CHF). Sleep apnea syndrome (SAS) is highly prevalent in CHF and is also associated with poor prognosis. However, the association of LAE and SAS has not yet been investigated in patients with CHF.
Methods: We prospectively investigated 274 consecutive patients with systolic CHF and left ventricular ejection fraction (LVEF) <40%. Sleep apnea syndrome was determined by screening devices (nasal flow and pulse oxymetry) and/or polysomnography (PSG). Left atrial size was determined by M-mode echocardiography.
Results: A total of 274 patients with congestive heart failure were investigated (Age 71 ± 11 years, 75% men, 64% ischemic cardiomyopathy (ICM), 64% overweight, 78% New York Heart Association (NYHA) class III-IV, 20% permanent atrial fibrillation (AF), LVEF 28 ± 9,3%). A total of 85% of patients had sleep apnea syndrome, defined by an apnea/hypopnea index (AHI) ≥5/h. LAE (defined by left atrial diameter (LAD) ≥ 45 mm) was present in 58% of patients. Independent predictors for LAE in univariate and multivariate analyses were SAS, AF, left ventricular enddiastolic diameter (LVEDD) and mitral regurgitation (MR) ≥II°.
Conclusion: In patients with CHF, SAS is an independent predictor for LAE. SAS-induced nocturnal hypoxaemia and cardiac sympathetic hyperactivity may contribute to atrial remodelling in CHF patients.
- © 2011 by American Heart Association, Inc.