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Portable recording for detecting sleep disorder breathing in patients under the care of a heart failure clinic

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Abstract

Background

Sleep disordered breathing (SDB) has important clinical implications in patients with congestive heart failure (CHF). We performed portable recording in unselected CHF patients on contemporary therapy. Data on the interactions of SDB in patients supervised at heart failure clinics are rare and we illustrate diversities of obstructive sleep apnoea (OSA) and central sleep apnoea (CSA).

Methods

We studied 176 consecutive subjects on contemporary medical therapy with a median left ventricular ejection fraction of 25.0 % (range 7–35 %) and median NT-pro BNP levels of 3,413.0 pg/ml (range 305.1–35,000.0 pg/ml). Participants underwent prospective overnight portable recording.

Results

50 % presented with an at least moderate form of nocturnal breathing disorder [apnoea–hypopnoea index (AHI) ≥15/h]. Only 15 patients (17.1 %) with AHI ≥15/h reported excessive daytime sleepiness. Irrespective of left ventricular ejection fraction, patients with CSA had higher levels of NT-pro BNP compared to patients with OSA (differences in medians = 2,639.0 pg/ml, p = 0.016), and compared to patients with an AHI <15/h (differences in medians = 2,710.0 pg/ml, p < 0.001). OSA affected 26 patients (14.8 %).

Conclusions

Patients with severe stable CHF on contemporary therapy have a prevalence of 50.0 % of moderate to severe SDB. The natural cascade of the failing heart is initially characterised by absent SDB or OSA, whereas end-stage CHF is associated with CSA.

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Acknowledgments

An Embletta® recording device and technical support was kindly provided by Vivisol Austria. We would like to thank Mrs Monika Knoetig, biomedical scientist, for assistance in polygraphic related patient care.

Conflict of interest

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Authors and Affiliations

  1. Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    Peter Dolliner, Senta Graf, Martin Huelsmann & Guenter Steurer

  2. Department of Nuclear Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    Peter Dolliner, Lindsay Brammen & Philipp Ubl

  3. Division of Pneumology, Department of Internal Medicine II, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    Leopold Stiebellehner

  4. Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    Andreas Gleiss

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  1. Peter Dolliner
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Correspondence to Peter Dolliner.

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Dolliner, P., Brammen, L., Graf, S. et al. Portable recording for detecting sleep disorder breathing in patients under the care of a heart failure clinic. Clin Res Cardiol 102, 535–542 (2013). https://doi.org/10.1007/s00392-013-0563-4

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  • DOI: https://doi.org/10.1007/s00392-013-0563-4

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