Tissue Doppler Imaging predicts central sleep apnea in patients with chronic heart failure: data from the Daunia Registry

Eur J Clin Invest. 2015 Nov;45(11):1153-60. doi: 10.1111/eci.12520. Epub 2015 Sep 13.

Abstract

Background: Tissue Doppler imaging (TDI) is used to improve risk stratification in patients with chronic heart failure (CHF). So far, few studies have used this method to investigate the characteristics of subjects with CHF and Cheyne-Stokes breathing (CSB). The aim of this study was therefore to evaluate whether TDI assessment may predict the presence of CSB in patients with CHF.

Materials and methods: A total of 41 consecutive patients with CHF enrolled in the Daunia Heart Failure Registry underwent echocardiography assessment and nocturnal polygraphy to evaluate the presence of sleep apnea and CSB. Conventional echocardiography and TDI parameters were calculated. We have also quantified by TDI a combined index (EAS index) of diastolic and systolic performance: E'/(A' × S').

Results: Subjects with evidence of CSB (N = 8) were characterized by lower values of A' (5·03 ± 2·64 vs. 7·88 ± 2·64 cm/s, P < 0·01). A' and EAS index values were related to Cheyne-Stokes episode rates (r = -0·49 and 0·52, P < 0·05 and <0·01 respectively), EAS index values also with the number of episodes of central apnea (r = 0·39, P < 0·05). A' values predicted the presence of CSB at poly-somnography examination with an OR 0·62 (95% CI 0·40-0·96, P < 0·05) even after correction for age and gender.

Conclusions: Tissue Doppler imaging values (A') are associated with the presence of sleep apnea at nocturnal polygraphy.

Keywords: A'; Cheyne-Stokes breathing; chronic heart failure; echocardiography; nocturnal polygraphy; tissue doppler imaging.

MeSH terms

  • Aged
  • Cheyne-Stokes Respiration / diagnosis*
  • Cheyne-Stokes Respiration / epidemiology
  • Chronic Disease
  • Echocardiography, Doppler*
  • Female
  • Heart Failure / diagnostic imaging*
  • Heart Failure / epidemiology
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Polysomnography
  • Registries*
  • Sleep Apnea, Central / diagnosis*
  • Sleep Apnea, Central / epidemiology
  • Sleep Apnea, Obstructive / epidemiology