Sleep & breathing = Schlaf & Atmung · 2011
Symptoms of sleep apnoea in chronic heart failure--results from a prospective cohort study in 1,500 patients.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Bitter Thomas, Westerheide Nina, Hossain Sajid Mohammed, Prinz Christian, Horstkotte Dieter, Oldenburg Olaf
Аннотация
BACKGROUND: In patients with chronic heart failure, sleep-disordered breathing (SDB) is a common co-morbidity worsening prognosis. The aim of this study was to investigate whether assessment of specific symptoms can elucidate presence of SDB in these patients.
METHODS: A prospective questionnaire scoring investigation on possible symptoms of sleep apnoea (nocturia, fatigue, daytime sleepiness, snoring, nocturnal sweating, witnessed apnoea's, nap) was conducted in 1,506 consecutive patients with stable chronic heart failure (LVEF ≤45%, NYHA ≥2). Afterwards, polysomnography or polygraphy, capillary blood gas analysis, echocardiography, and cardiopulmonary exercise testing were performed.
RESULTS: Adjusted for all significant covariates, snoring (p < 0.01) was the only symptom independently associated with OSA, while witnessed apnoeas (p = 0.02) and fatigue (p = 0.03) independently predicted for CSR. As additional parameters, higher BMI (threshold 26.6; p < 0.01) and higher pCO(2) (threshold 37.6 mmHg; p < 0.01) were independently associated with OSA and male gender (p < 0.001) and lower pCO(2) (threshold 35.0 mmHg; p < 0.001) with CSA. Cumulative questionnaire score results did not sufficiently (OSA--sensitivity 0.40, specificity 0.74; CSA--sensitivity 0.57, specificity 0.59) predict SDB.
CONCLUSION: Although in chronic heart failure patients with either OSA or CSA specific symptoms are apparent, combining clinical data, demographic data, and capillary blood gas analysis results appears favourable to determine the presence of SDB.
METHODS: A prospective questionnaire scoring investigation on possible symptoms of sleep apnoea (nocturia, fatigue, daytime sleepiness, snoring, nocturnal sweating, witnessed apnoea's, nap) was conducted in 1,506 consecutive patients with stable chronic heart failure (LVEF ≤45%, NYHA ≥2). Afterwards, polysomnography or polygraphy, capillary blood gas analysis, echocardiography, and cardiopulmonary exercise testing were performed.
RESULTS: Adjusted for all significant covariates, snoring (p < 0.01) was the only symptom independently associated with OSA, while witnessed apnoeas (p = 0.02) and fatigue (p = 0.03) independently predicted for CSR. As additional parameters, higher BMI (threshold 26.6; p < 0.01) and higher pCO(2) (threshold 37.6 mmHg; p < 0.01) were independently associated with OSA and male gender (p < 0.001) and lower pCO(2) (threshold 35.0 mmHg; p < 0.001) with CSA. Cumulative questionnaire score results did not sufficiently (OSA--sensitivity 0.40, specificity 0.74; CSA--sensitivity 0.57, specificity 0.59) predict SDB.
CONCLUSION: Although in chronic heart failure patients with either OSA or CSA specific symptoms are apparent, combining clinical data, demographic data, and capillary blood gas analysis results appears favourable to determine the presence of SDB.
Предметные рубрики MeSH
AgedBody Mass IndexCheyne-Stokes RespirationCohort StudiesComorbidityCross-Sectional StudiesEchocardiographyFemaleGermanyHealth SurveysHeart FailureHumansMaleMass ScreeningMiddle AgedPolysomnographyProspective StudiesRisk FactorsSex FactorsSleep Apnea SyndromesSleep Apnea, CentralSleep Apnea, ObstructiveSurveys and Questionnaires