Background: Sleep-disordered breathing (SDB) is a widely spread co-morbidity in patients with chronic heart failure (HF) that not only leads to a poor quality of life, but also a shorter life expectancy.
Methods: A total of 132 patients with chronic HF (mean age: 67 ± 11 y, 23% female, left ventricular ejection fraction [LVEF] 37 ± 13%, body mass index [BMI] 28.9 ± 5.2 kg/m2, New York Heart Association [NYHA] class 2.2 ± 0.7) underwent polygraphy screening between 2011 and 2014. Patients were screened for SDB using the Embletta portable diagnostic system. SDB was defined as an apnea-hypopnea index ≥5/h. Patients with LVEF≤40% were categorized as HF with reduced ejection fraction [HFrEF], LVEF>40% as HF with preserved ejection fraction [HFpEF].
Results: A total of 58 (44%) patients were diagnosed to have SDB and showed an increased apnea-hypopnea index. Patients with SDB (mean age: 68 ± 10 y, 17% female, LVEF 33 ± 12%, BMI 28.9 ± 5.9 kg/m2, NYHA class 2.3 ± 0.7) showed lower LVEF compared to patients without SDB (33 ± 12% vs. 40 ± 13%, p < 0.05). In patients with HFrEF (n = 47, 81%) SDB was more common than in patients with HFpEF (n = 11, 19%). Logistic regression analysis showed that reduced LVEF and higher creatinine level were predictive (both p < 0.05) for increased apnea-hypopnea index.
Conclusion: In patients with chronic HF, predictors of SDB include reduced LVEF and high level of creatinine. This fact buttresses the view that patients with more advanced HF are more likely to develop SDB. Screening for SDB provides an easy tool to identify patients with this co-morbidity.