Sleep-disordered breathing in heart failure patients with different etiologies

Clin Cardiol. 2022 Jul;45(7):778-785. doi: 10.1002/clc.23840. Epub 2022 May 10.

Abstract

Background: The prevalence of sleep-disordered breathing (SDB) is closely related to the severity of heart failure (HF), and the severity of HF is different in patients with HF of different etiologies.

Hypothesis: This study aimed to explore the prevalence of SDB in patients with HFof different etiologies.

Methods: Hospitalized HF patients were consecutively enrolled. All patients underwent portable overnight cardiorespiratory polygraphy. Patients were divided into five groups according to the etiology of HF: ischemic, hypertensive, myocardial, valvular, and arrhythmic. The prevalence of SDB and clinical data was compared among the five groups.

Results: In total, 248 patients were enrolled in this study. The prevalence of SDB in HF was 70.6%, with the prevalence of obstructive sleep apnea (OSA) at 47.6% and central sleep apnea (CSA) at 23.0%. Patients were divided into five groups: ischemic, hypertensive, myocardial, valvular, and arrhythmic. The prevalence of SDB among the five groups was 75.3%, 81.4%, 77.8%, 51.9%, and 58.5% (p = .014), respectively. The prevalence of OSA among the five groups was 42.7%, 72.1%, 36.1%, 37.0%, and 49.1% (p = .009), whereas the CSA was 32.6%, 9.3%, 41.7%, 14.8%, and 9.4% (p < .001), respectively.

Conclusions: SDB is common in HF patients. The prevalence and types of SDB varied in HF with different etiologies, which may be related to the different severities of HF. SDB was highly prevalent in patients with ischemic, hypertensive, and myocardial HF. Hypertensive HF patients were mainly complicated with OSA, while myocardial HF patients were mainly complicated with CSA. Both conditions were highly prevalent in ischemic HF patients. The prevalence of SDB was relatively low in valvular and arrhythmic HF patients, and OSA was the main type.

Keywords: etiologies; heart failure; prevalence; sleep-disordered breathing.

MeSH terms

  • Heart Failure* / complications
  • Heart Failure* / diagnosis
  • Heart Failure* / epidemiology
  • Humans
  • Prevalence
  • Sleep Apnea Syndromes* / complications
  • Sleep Apnea Syndromes* / diagnosis
  • Sleep Apnea Syndromes* / epidemiology
  • Sleep Apnea, Obstructive* / complications
  • Sleep Apnea, Obstructive* / diagnosis
  • Sleep Apnea, Obstructive* / epidemiology