Effect of respiratory therapy on the prognosis of chronic heart failure patients complicated with sleep-disordered breathing – A pilot efficacy trial

Hiroyuki Satake, Koichiro Sugimura, Yoshihiro Fukumoto, Koji Fukuda, Makoto Nakano, Masateru Kondo, Shigefumi Fukui, Hiromasa Ogawa, Tsuyoshi Shinozaki, Hiroaki Shimokawa

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)

Abstract

Background: Sleep-disordered breathing (SDB) has been reported to influence mortality and occurrence of ventricular tachyarrhythmia in patients with chronic heart failure (CHF). It remains to be elucidated, however, whether respiratory therapy (RT) can affect the occurrence of fatal ventricular tachyarrhythmia in CHF patients with SDB. Methods and Results: We prospectively examined whether the severity of SDB was associated with fatal cardiac events in CHF patients and, if so, whether RT for SDB improved prognosis. We enrolled 95 patients with stable CHF, in whom SDB was examined on overnight polygraphy. The severity of SDB was quantified using the apnea-hypopnea index (AHI). All patients with AHI ≥10 (n=42) at initial evaluation were recommended to have RT, such as home oxygen therapy and continuous positive airway pressure, and 24 agreed to this. During the follow-up period of 29±17 months, 8 ventricular tachyarrhythmias occurred and 14 of the 95 patients died. On multivariate proportional hazard analysis AHI ≥5 was a risk factor for fatal arrhythmic events (P=0.026). Although RT significantly reduced AHI, it did not significantly reduce the event rates, but 4 patients with AHI <5 on RT had no fatal arrhythmic events or death. Conclusions: SDB is an independent prognostic factor and thus an important therapeutic target in CHF patients.

Original languageEnglish
Pages (from-to)130-138
Number of pages9
JournalCirculation Journal
Volume80
Issue number1
DOIs
Publication statusPublished - 2015 Dec 25

Keywords

  • Chronic heart failure
  • Respiratory therapy
  • Sleep-disordered breathing

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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