RT Journal Article
SR Electronic
T1 The heterogeneity of obstructive sleep apnoea: Congestion leads to longer respiratory cycle lengths in heart failure
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P447
VO 40
IS Suppl 56
A1 Christina Efken
A1 Thomas Bitter
A1 Britta Körber
A1 Kevin Bullert
A1 Dieter Horstkotte
A1 Olaf Oldenburg
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P447.abstract
AB It is controversial if heart failure (HF) can influence obstructive sleep apnoea (OSA) per se. Previous studies documented increased cycle lengths (CL), ventilation lengths (VL), and circulatory delays (CD) of OSA in HF patients. Aim of the present study was to verify these results in a cohort of well-defined HF patients and to investigate possible interactions of HF and OSA.Methods: 39 patients with OSA (apnoea-hypopnoea index, AHI > 10/h) with (NYHA ≥ II, LV-EF ≤ 40%; n=26, 18 male, 67.2±9.4 years) and without (EF ≥ 50%, NT-proBNP < 400; n=13, 6 male, 72.7±5.8 years) HF underwent simultaneous right- and left-heart catheterization within 12h of cardiorespiratory polygraphy.Results: AHI as well as obstructive apnoea-index (oAI) were comparable in both groups (AHI= 34.3 ± 26.5/h vs. 32.3±18.0, p=n.s.; oAI=8.5 ± 7.8/h vs. 10.0±10.8, p=n.s.). We were able to verify increased CL, VL, time to peak ventilation (TTPV) and circulatory delay (CD) in patients with HF (CL: 37.8±10.6s vs. 46.0±10.0s, p=0.024; VL: 21.3±7.1 vs. 25.4±6.3, p=0.044; TTPV: 8.3±2.5s vs. 10.6±3.0s, p=0.021; CD: 22.6±3.7s vs. 28.5±7.5s, p=0.005). Apnoea length (AL) was higher in HF patients (16.5±3.9s vs. 20.5±4.9s, p=0.013). Positive and robust correlations between parameters of OSA and degree of congestion were found in OSA patients with HF exclusively: CL, VL, and TTPV increased with elevation of PCWP (CL: r=0.53; p=0.006; VL: r=0.55; p=0.004; TTPV: r=0.47; p=0.015).Respiratory parameters of OSA (CL, VL, TTPV) correlate with the degree of congestion in patients with OSA and HF, but not in non-HF patients with OSA. These results point to a reciprocal relationship of HF and OSA severity.