Sleep Disordered Breathing Common in People with Heart Failure

A new sleep study from China found that sleep-disordered breathing (SDB) was common in patients with heart failure, with prevalence and types varying across different etiologies.

Investigators believed that these findings could be related to the different severities of heart failure detailed in the study.

Sleep-disordered breathing is predominantly divided into obstructive sleep apnea (OSA) and central sleep apnea (CSA), conditions that are prominent in patients with heart failure with a prevalence of approximately 50-70%.

Meanwhile the severity of heart failure has been known to vary across etiologies, which suggests that the prevalence and types of SDB vary as well.

As such, an investigative team led by Tao Wang, MD, Zhongda Hospital, Southeast University in China, investigated the prevalence and characteristics of patients with SDB with heart failure of different etiologies.

Patients who were admitted to the Department of Cardiology at Zhongda Hospital between January 2021 and October 2021 were enrolled in the study.

Inclusion criteria featured adherence to the diagnostic criteria of the 2016 European Society of Cardiology guidelines for heart failure, chronic or stable acute heart failure, between the age of 18-85 years old, and signed informed consent.

Patients who had heart surgery within 6 months of the study, acute myocardial infarction, severe renal insufficiency, renal transplantation, active liver disease or liver dysfunction, active infection, or a history of COPD were excluded.

The etiology of heart failure was defined by past medical history and echocardiogram results, and clinical data od patients such as age, sex, anthropometric data, smoking and drinking history, and snoring history were recorded.

Patients were divided into 5 distinct groups according to the etiology of heart failure, including ischemic, hypertensive, myocardial, valvular, and arrhythmic.

After enrollment, NYHA classification was assessed in all patients, and the 6-minute walk test (6MWT) was performed 3 days following hospital admission according to guidelines by the American Thoracic Society.

The Epworth sleepiness scale was also performed immediately after enrollment, and blood samples were collected during fasting following testing of the N-terminal brain natriuretic peptide.

A total of 248 patients with an average age of 70 years were enrolled in the study, 132 of whom were men.

The data indicated that the prevalence of SDB in heart failure was 70.6%, with OSA in particular at 47.6% and CSA at 23%.

Sleep-disordered breathing was most prevalent in the hypertensive group (81.4%) and least prevalent in the valvular group (51.9%).

Meanwhile, SDB was prevalent in 75.3% of the patients in the ischemic group, 77.8% in the myocardial group, and 58.5% in the arrhythmic.

The prevalence of OSA among the 5 groups was 42.7% for the ischemic group, 72.1% for hypertensive, 36.1% for myocardial, 37.0% for valvular, and 49.1% for the arrhythmic group (P = .009).

Regarding CSA, prevalence was 32.6%, 9.3%, 41.7%, 14.8%, and 9.4% (p < .001), respectively.

The study, "Sleep-disordered breathing in heart failure patients with different etiologies," was published online in Clinical Cardiology.