Chest
Clinical InvestigationsBrain Natriuretic Peptide in Patients With Congestive Heart Failure and Central Sleep Apnea
Section snippets
Patients
We performed a prospective study in 90 consecutive patients of both sexes who had CHF due to systolic dysfunction (left ventricular ejection fraction [LVEF] ≤ 45%) and were being treated in the cardiology service of our hospital. All patients were receiving standard drug therapy for their CHF and were clinically stable, a condition defined as the absence of changes in the signs or symptoms of cardiac failure or in the medication dosage within the 4 weeks preceding their enrollment in the study.
Results
Five of the 90 patients (6%) were excluded from the study because they were found to have obstructive sleep apneas (AHI ≥ 10; obstructive apneas-hypopneas representing > 30% of all respiratory events). Of the 85 patients with CHF who were finally included in the study, 25 patients (28%) also had CSR-CSA (CHF-CSR-CSA group) with a mean AHI of 30.8 ± 3.4 and a mean DI of 37.2 ± 1.3. The remaining 60 patients (66%) had CHF without any SRBDs associated (CHF-no-SRBD group), and had a mean AHI of
Discussion
Our results show that patients with CHF and associated CSR-CSA present higher BNP levels than patients with CHF but without SRBDs. This difference persists after adjustment for age, gender, LVEF, plasma creatinine concentration, and the presence of diabetes. AHI and DI explain 30.5% of the variability in the BNP level. Finally, plasma BNP concentrations show high specificity and negative predictive value for the detection of CSR-CSA in patients with stable CHF.
CHF is a highly prevalent
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This study was funded by RedRespira grant ISCiii-RTIC-03/11.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestjournal.org/misc/reprints.shtml).