RT Journal Article
SR Electronic
T1 Implications of revised rules on scoring apneic and hypopneic respiratory events in heart failure patients with nocturnal Cheyne-Stokes respiration
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2040
VO 42
IS Suppl 57
A1 Jessica Heinrich
A1 Jens Spießhöfer
A1 Thomas Bitter
A1 Henrik Fox
A1 Dieter Horstkotte
A1 Olaf Oldenburg
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P2040.abstract
AB Scoring definitions and therefore data on prognostic impact of sleep-disordered breathing (SDB) on survival in heart failure (HF) patients are based on 1999 and 2007 definitions of the American Academy of Sleep Medicine (AASM). Thus, a recent (09/2012) update of these scoring rules include a more broadly definition especially on hypopneic events. This study investigates the impact of the new scoring rules on apnea and hypopnea events in a cohort of well characterized HF patients (NYHA ≥ II, LV-EF ≤ 45%) with nocturnal Cheyne-Stokes respiration.Cardiorespiratory polygraphy recordings of 35 HF (NYHA 2.7 ± 0.7; LV-EF = 30.2 ± 7.5%; 30 male; 72 ± 12 years) were scored according to 2007 (recommended) and 2012 recommendations.Apnea hypopnea index according to 2007 recommended scoring rules was 39.7 ± 13.6/h compared to 44.3 ± 12.7/h by using the revised 2012 rules (p<0.001). This difference is based on a highly significant difference in hypopnea index (13.3 ± 12.1/h vs. 18.0 ± 13.5, p<0.001), whereas there was no difference in apnea index (26.4 ± 12.8/h vs. 26.3 ± 12.9/h, p=0.353).Applications of new AASM scoring rules lead to a higher AHI, which is based on a less strict definition of hypopneas. To date and especially in HF patients, prognostic data on SDB in general and Cheyne-Stokes respiration in particular are based on 2007’s strict definitions. With application of the new AASM recommendations, mortality data needs to be reanalyzed and graduation of SDB severity has to be adapted. In addition, data on prognostic impact on hypopneas itself is warranted as are studies differentiating central and obstructive hyponeic events.