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

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• 作者：Michael Arzt ; MD^a ; ^{michael.arzt@klinik.uni-regensburg.de" class="auth_mail" title="E-mail the corresponding author} ; Holger Woehrle ; MD^b ; ^c ; Olaf Oldenburg ; MD^d ; Andrea Graml ; Dipl Stat^c ; Anna Suling ; PhD^e ; Erland Erdmann ; MD^f ; Helmut Teschler ; MD^g ; Karl Wegscheider ; PhD^e ; for the SchlaHF Investigators
• 关键词：Cheyne-Stokes respiration ; heart failure ; sleep apnea ; sleep-disordered breathing
• 刊名：JACC: Heart Failure
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：4
• 期：2
• 页码：116-125
• 全文大小：863 K

文摘

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 SDB. (Prevalence, Clinical Characteristics and Type of Sleep-disordered Breathing in Patients With Chronic, Symptomatic, Systolic Heart Failure; NCT01500759)