Document Detail


Central sleep apnea in left ventricular dysfunction: prevalence and implications for arrhythmic risk.
MedLine Citation:
PMID:  12578876     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The prevalence and characteristics of sleep-disordered breathing in patients with asymptomatic left ventricular (LV) dysfunction are unknown. Therefore, we evaluated the prevalence of sleep-disordered breathing in patients with LV dysfunction without overt heart failure and tested the hypothesis that sleep-disordered breathing is linked to greater hemodynamic and autonomic impairment. METHODS AND RESULTS: We studied 47 patients with LV ejection fractions <or=40% without any history of heart failure. Central sleep apnea (CSA), as defined by an apnea-hypopnea index >or=15/h, was present in 26 patients (55%), 17 (36%) of whom had severe CSA (apnea-hypopnea index >or=30/h). Obstructive sleep apnea was evident in 5 patients (11%). The prevalence and severity of CSA were higher in patients with ischemic cardiomyopathy than in patients with nonischemic cardiomyopathy (P<0.05). Exercise tolerance and echocardiographic indices of systolic and diastolic function were similar in patients without CSA, with mild CSA, and with severe CSA. Heart rate variability was markedly depressed in patients with CSA (P<0.05). Patients with severe CSA also had a higher incidence of nonsustained ventricular tachycardia (P=0.05). CONCLUSIONS: CSA is highly prevalent in patients with asymptomatic LV dysfunction. The severity of CSA may not be related to the severity of hemodynamic impairment. Severe CSA is associated with impaired cardiac autonomic control and with increased cardiac arrhythmias.
Authors:
Paola A Lanfranchi; Virend K Somers; Alberto Braghiroli; Ugo Corra; Ermanno Eleuteri; Pantaleo Giannuzzi
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Circulation     Volume:  107     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-02-11     Completed Date:  2003-02-26     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  727-32     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, Fondazione Salvatore Maugeri IRCCS, Veruno, Italy. paola-lanfranchi@CRHSC.umontreal.ca
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MeSH Terms
Descriptor/Qualifier:
Arrhythmias, Cardiac* / etiology
Autonomic Nervous System / physiopathology
Circadian Rhythm
Comorbidity
Coronary Artery Disease / diagnosis,  epidemiology,  physiopathology
Echocardiography
Electrocardiography, Ambulatory
Exercise Test
Female
Heart / innervation,  physiopathology
Humans
Male
Middle Aged
Polysomnography
Prevalence
Prospective Studies
Risk
Sleep Apnea, Central / diagnosis*,  epidemiology,  physiopathology
Stroke Volume
Ventricular Dysfunction, Left / diagnosis*,  epidemiology,  physiopathology
Grant Support
ID/Acronym/Agency:
HL40602/HL/NHLBI NIH HHS; HL61560/HL/NHLBI NIH HHS; HL65176/HL/NHLBI NIH HHS; RR00585/RR/NCRR NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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