Cheyne-stokes respiration and prognosis in modern-treated congestive heart failure

TY - JOUR

T1 - Cheyne-stokes respiration and prognosis in modern-treated congestive heart failure

AU - Hagenah, Gerrit

AU - Zapf, Antonia

AU - Schüttert, Jan Bernd

PY - 2010/8

Y1 - 2010/8

N2 - In patients with congestive heart failure (CHF), a high prevalence of sleep-disordered breathing has been described. Cheyne-Stokes respiration (CSR) is present in up to 40% of patients with CHF. During the last decade, the medical treatment has been substantially improved. This study was designed to analyze the prognosis of CSR in modern-treated patients with CHF. For this purposes, in 57 patients with CHF who received modern treatment, a 5-year follow-up after initial full night polysomnography was performed. The mean follow-up period was 38 +/- 18 months. Mean age was 62 +/- 13 years and the mean ejection fraction was 25 +/- 7 percent. Respiratory polygraphy revealed CSR with a respiratory disturbance index >5 per hour of sleep in 39 of 57 patients. Twelve patients died. CSR was only characterized by a tendency of worsening (log-rank test, p = 0.25). However, there was a significant difference toward positive outcome for patients who received cardiac resynchronization therapy (log-rank test, p = 0.036). Using Multivariate Cox's proportional hazard regression with the factors resynchronization and CSR, the effect of resynchronization was almost significant (p = 0.08). In conclusion, no significant change of Cheyne-Stokes prevalence can be found in our small group of modern-treated patients with CHF. Cardiac resynchronization therapy was associated with improved patient outcome.

AB - In patients with congestive heart failure (CHF), a high prevalence of sleep-disordered breathing has been described. Cheyne-Stokes respiration (CSR) is present in up to 40% of patients with CHF. During the last decade, the medical treatment has been substantially improved. This study was designed to analyze the prognosis of CSR in modern-treated patients with CHF. For this purposes, in 57 patients with CHF who received modern treatment, a 5-year follow-up after initial full night polysomnography was performed. The mean follow-up period was 38 +/- 18 months. Mean age was 62 +/- 13 years and the mean ejection fraction was 25 +/- 7 percent. Respiratory polygraphy revealed CSR with a respiratory disturbance index >5 per hour of sleep in 39 of 57 patients. Twelve patients died. CSR was only characterized by a tendency of worsening (log-rank test, p = 0.25). However, there was a significant difference toward positive outcome for patients who received cardiac resynchronization therapy (log-rank test, p = 0.036). Using Multivariate Cox's proportional hazard regression with the factors resynchronization and CSR, the effect of resynchronization was almost significant (p = 0.08). In conclusion, no significant change of Cheyne-Stokes prevalence can be found in our small group of modern-treated patients with CHF. Cardiac resynchronization therapy was associated with improved patient outcome.

KW - Aged

KW - Cardiac Pacing, Artificial

KW - Cheyne-Stokes Respiration

KW - Female

KW - Follow-Up Studies

KW - Heart Failure

KW - Humans

KW - Male

KW - Middle Aged

KW - Polysomnography

KW - Prognosis

KW - Retrospective Studies

KW - Sleep Apnea Syndromes

KW - Treatment Outcome

KW - Journal Article

U2 - 10.1007/s00408-009-9208-9

DO - 10.1007/s00408-009-9208-9

M3 - SCORING: Journal article

C2 - 20012640

VL - 188

SP - 309

EP - 313

JO - LUNG

JF - LUNG

SN - 0341-2040

IS - 4

ER -