Abstract 12194: Finding Out a Useful Parameter of Sleep Disordered Breathing in Chronic Heart Failure Patients
Background and Purpose: Sleep disordered breathing (SDB) is highly prevalent in patients with chronic heart failure (CHF). Though severity of SDB has been commonly assessed by apnea hypopnea index (AHI) using standard polysomnography (PSG), this method necessitates especially dedicated facilities and trained personnel. Thus, we tried to determine a practical threshold for detecting moderate SDB by investigating all admitted CHF patients with the use of pulse-oximetry data.
Methods: Consecutive stable CHF patients (N=136) were prospectively screened for the presence of SDB according to Japanese guideline for treatment of SDB. In patients who were suspected of having SDB from the data showing 3% oxygen desaturation index (ODI), standard PSG was performed. The relationship between parameters obtained by the PSG and pulse-oximetry were investigated.
Results: Of the 136 patients (81 male), average NYHA class and left ventricular ejection fraction (LVEF) were 2.2±0.7 and 46.9±17.9%, respectively. In 123 patients who were suspected of having SDB, 34 (28%) showed 5/h≦3%ODI<10/h and 77 (63%) were 3%ODI≧10/h. In 106 patients who had PSG, 80 (75%) showed apnea-hypopnea index (AHI)≧15/h and 38 (36%) were AHI≧30/h. The value of 3%ODI in screening test had statistically significant correlation with AHI by PSG (r=0.717). The regression line was AHI=1.27x3%ODI+8.38 (R2=0.514). To detect moderate SDB of AHI≧15/h, a receiver operating characteristics curve was generated to identify optimal cut off value of 3%ODI. The results are shown in the following Table. The diagnostic accuracy of 3%ODI in screening test was moderate, and 3%ODI≧9/h could estimate AHI≧15/h with moderate sensitivity and specificity irrespective of cardiac function presented by LVEF.
Conclusions: This study confirmed the high prevalence of SDB in Japanese CHF patients. Moreover, the value of 3%ODI>9/hr in screening test was effective in the detection of moderate SDB in CHF patients.
Author Disclosures: T. Nakashima: Other Research Support; Significant; TEIJIN PHARMA LIMITED. T. Ohkusa: Other Research Support; Significant; TEIJIN PHARMA LIMITED. T. Nao: Other Research Support; Significant; TEIJIN PHARMA LIMITED. N. Harada: None. Y. Wada: None. T. Ueyama: None. S. Kobayashi: None. Y. Ikeda: None. H. Sawatari: None. A. Chishaki: None. S. Ando: None. M. Yano: None.
- © 2014 by American Heart Association, Inc.