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Detection of the changes in cardiac function and sleep disordered breathing can be simultaneously and automatically performed by a nocturnal polygraphy with novel algorithm.

Session Poster Session 3

Speaker Tomoyuki Tobushi

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure: Comorbidities
  • Session type : Poster Session

Authors : T Tobushi (Chikushino,JP), T Kadokami (Chikushino,JP), K Abe (Chikushino,JP), R Nakamura (Chikushino,JP), S Ando (Fukuoka,JP)

T Tobushi1 , T Kadokami1 , K Abe1 , R Nakamura1 , S Ando2 , 1Saiseikai futsukaichi hospital, Cardiovascular Medicine - Chikushino - Japan , 2Kyushu University Hospital, Sleep Apnea Center - Fukuoka - Japan ,


?Background?Sleep disordered breathing (SDB) is a common comorbid condition with cardiac patients especially those with heart failure (HF) reportedly due to the changes in chemosensitivity, stimulation of pulmonary stretch receptors or prolonged circulation time. It is well known circulation time is prolonged in those with depressed cardiac function and can be a marker of cardiac output. Previously, we developed a novel automatic algorithm to determine finger to lung circulation time (LFCT) from nocturnal cardiorespiratory polygraphy data. As we hypothesized that this technique may be applied as a simplified and simultaneous detection tool of the changes in SDB severity and cardiac function, we tried to prove the usefulness of this technique in hospitalized cardiac patients. 
?Purpose?To determine whether a set of cardiorespiratory polygraphy data, one at just after admission and another at just before discharge after treatment, can trace the changes in SDB and cardiac function among cardiac patients including HF with preserved ejection (EF) fraction and with reduced EF. 
?Methods?We enrolled consecutively 118 cardiac patients with and without HF, of whom 98 patients completed nocturnal polygraphy including oxygen saturation monitoring and respiration twice before/after treatment. We measured SDB parameters and automatically detected LFCT from the data. We divided the patients into worsening HF group (n=55) and non-worsening HF group (n=35), though 8 patients were excluded because the judgements of worsening HF or not were controversial. Echocardiography data (EF, left ventricular end diastolic and end systolic diameter (LVDd/LVDs) and BNP were obtained. 
?Results?On admission, 63.7% of worsening HF and 54.2% of non-worsening HF had moderate to severe SDB. Patients with worsening HF group showed higher BNP values and improvement through HF treatment (563.6 ± 513.6 to 334.7 ± 265.6 pg/ml, p<0.05). 1st and 2nd cardiopulmonary polygraphy was performed at 3.5 ± 3.5 days and 11.2 ± 6.2 days after admission respectively (mean interval: 7.7 ± 4.5 days). RDI of patients with worsening HF improved through the treatment from 25.5 ± 16.5 to 18.2±12.9 (/h) significantly but not in non-worsening HF group. We could obtain LFCT data from 100% of the patients even from those with RDI<5/h. LFCT values significantly shortened only in patients with worsening HF group with low EF (EF < 40%: 26.9 ± 7.6 to 24.2 ± 6.1 (s), p<0.05), dilated LVDd (LVDd?50mm: 27.3±7.2 to 25.1±6.4 (s), p<0.05) or dilated LVDs (LVDs?40mm: 26.9±7.3 to 24.9±6.7, p<0.05).
?Conclusion?Simple nocturnal cardiopulmonary monitor can simultaneously trace the changes in the status of SDB and cardiac output represented by LFCT during treatment. In the patients with HF with preserved EF, SDB improved though cardiac output remained at same level, while both parameters improved in HF with reduced EF, suggesting that this technique can be a useful tool for treating cardiac patients.

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