Abstract 19206: Prevalence of Sleep Disordered Breathing and Mortality Follow-Up in an Acute Decompensated Heart Failure Population
Introduction: The Cardiovascular Improvements with Minute Ventilation-targeted Adaptive Servo-Ventilation (ASV) Therapy in Heart Failure (CAT-HF) trial was designed to evaluate outcomes in hospitalized patients with reduced and preserved ejection fraction (HFrEF and HFpEF) randomized to treatment with ASV or usual care. SDB testing is not routine in clinical practice and little data exists on prevalence in acute decompensated HF (ADHF) patients.
Hypothesis: Testing a hospitalized HF population is feasible and demonstrates significant prevalence of SDB.
Methods: As part of CAT-HF screening, consented hospitalized HF patients were screened for presence and severity of SDB using overnight polygraphy (PG) measuring respiratory events and pulse oximetry. Patients not randomized were followed-up with a phone call at 6 months to determine outcome (death). Randomized subjects were followed according the CAT-HF study protocol. SDB classification was performed by a core lab.
Results: The registry included 373 patients (126 were randomized), 298 of which had evaluable PG results. Characteristics of evaluable patients: 66.0 ± 13.8 years old, 73% male and 73% HFrEF. Of the 298 evaluable tests, 11.7% had no SDB (AHI <5), 26.8% had mild SDB (AHI 5-14), 21.5% had moderate SDB (AHI 15-29), and 39.9% had severe SDB (AHI ≥ 30). Prevalence of SDB was 65.1% in HFrEF patients and 53.1% in HFpEF patients. Of the randomized and non-randomized cohorts overall, 31.8% had predominantly obstructive SDB vs 52.4% with predominantly central SDB; the remaining 15.8% were either normal for SDB or had invalid test results. At 6 months, 12.6% (25/199) of patients in the non-randomized registry were reported deceased compared to 6.3% (7/112) in the randomized cohort.
Conclusions: Evaluation of the CAT-HF registry demonstrates that the prevalence of SDB in a hospitalized HF population is significant and exceeds the prevalence seen in chronic HF. The non-randomized group shows high 6 month mortality providing an opportunity for improved outcomes with regular clinical follow up. Screening for SDB in hospitalized HF patients is feasible.
Author Disclosures: O. Oldenburg: Consultant/Advisory Board; Significant; ResMed. D. Whellan: Consultant/Advisory Board; Significant; ResMed. J. Lindenfeld: Consultant/Advisory Board; Significant; ResMed. M. Fiuzat: Consultant/Advisory Board; Modest; ResMed. N. Punjabi: Consultant/Advisory Board; Significant; ResMed. A. Benjafield: Employment; Significant; ResMed. A. Blase: Employment; Significant; ResMed. H. Woehrle: Employment; Significant; ResMed. C. O’Connor: Consultant/Advisory Board; Significant; ResMed.
- © 2016 by American Heart Association, Inc.