Prevalence and Predictors of Sleep-Disordered Breathing in Patients With Stable Chronic Heart Failure The SchlaHF Registry

被引:151
作者
Arzt, Michael [1 ]
Woehrle, Holger [2 ,3 ]
Oldenburg, Olaf [4 ]
Graml, Andrea [3 ]
Suling, Anna [5 ]
Erdmann, Erland [6 ]
Teschler, Helmut [7 ]
Wegscheider, Karl [5 ]
机构
[1] Univ Hosp Regensburg, Dept Internal Med 3, Regensburg, Germany
[2] Resp Ctr Ulm, Sleep & Ventilat Ctr Blaubeuren, Ulm, Germany
[3] ResMed Sci Ctr, Martinsried, Germany
[4] Heart & Diabet Ctr North Rhine Westphalia, Dept Cardiol, Bad Oeynhausen, Germany
[5] Univ Med Ctr Hamburg Eppendorf, Dept Med Biometry & Epidemiol, Hamburg, Germany
[6] Univ Hosp Cologne, Ctr Heart, Clin Internal Med 3, Cologne, Germany
[7] Univ Duisburg Essen, Univ Hosp Essen, Dept Pneumol, Ruhrlandklin,West German Lung Ctr, Essen, Germany
关键词
Cheyne-Stokes respiration; heart failure; sleep apnea; sleep-disordered breathing; ADAPTIVE SERVO-VENTILATION; CAPILLARY WEDGE PRESSURE; VENTRICULAR DYSFUNCTION; APNEA; POPULATION; APNEALINK(TM); EPIDEMIOLOGY; RATIONALE; MORTALITY; COMMUNITY;
D O I
10.1016/j.jchf.2015.09.014
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVES This prospective study investigated the prevalence of sleep-disordered breathing (SDB) and its predictors in patients with stable chronic heart failure (HF). BACKGROUND SDB is increasingly recognized as being important in patients with HF. METHODS The multicenter SchlaHF (Sleep-Disordered Breathing in Heart Failure) registry provides demographic and clinical data on chronic, stable, symptomatic patients with HF (New York Heart Association functional class >= II; left ventricular rejection fraction <= 45%). Moderate-to-severe SDB (apnea-hypopnea index <= 15/h) was determined by a 2-channel screening device (ApneaLink, ResMed, Sydney, Australia). RESULTS Data from 6,876 patients were analyzed. The prevalence of moderate-to-severe SDB was 46%, with a significant sex difference: 36% in women (n = 1,448) versus 49% in men (n = 5,428). Prevalence of SDB rose with increasing age (31%, 39%, 45%, 52%, and 59% in those age <= 50, >50 to 60, >60 to 70, >70 to 80, and >80 years, respectively). Risk factors for SDB were body mass index (per 5 units; odds ratio [OR]: 1.29; 95% confidence interval [CI]: 1.22 to 1.36), left ventricular rejection fraction (per 5% decrement from 45%; OR: 1.10; 95% CI: 1.06 to 1.14), age (per 10-year difference to 60 years; OR: 1.41; 95% CI: 1.34 to 1.49), atrial fibrillation (OR: 1.19; 95% CI: 1.06 to 1.34), and male sex (OR: 1.90; 95% CI: 1.67 to 2.17). CONCLUSIONS SchlaHF registry data demonstrate a high prevalence of SDB in a representative population of stable patients with chronic HF receiving contemporary medical management. Male sex, age, body mass index, and the severity of both symptoms and left ventricular dysfunction were clinical predictors for prevalent SOB. (Prevalence, Clinical Characteristics and Type of Sleep-disordered Breathing in Patients With Chronic, Symptomatic, Systolic Heart Failure; NCT01500759) (C) 2016 by the American College of Cardiology Foundation.
引用
收藏
页码:116 / 125
页数:10
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