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Pathophysiological and clinical relevance of simplified monitoring of nocturnal breathing disorders in heart failure patients
Author(s) -
Pinna Gian Domenico,
Maestri Roberto,
Mortara Andrea,
Johnson Paul,
Andrews David,
Ponikowski Piotr,
Witkowski Tomasz,
Robbi Elena,
La Rovere Maria Teresa,
Sleight Peter
Publication year - 2009
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1093/eurjhf/hfp006
Subject(s) - medicine , heart failure , ejection fraction , cardiology , clinical significance , pathophysiology , hazard ratio , nocturnal , breathing , periodic breathing , anesthesia , confidence interval
Aims Nocturnal breathing disorders in the form of periodic breathing (PB) are very common in heart failure (HF) patients. There is an increasing interest in simple and affordable tools to screen patients and monitor these disorders at home on a long‐term basis. We aimed to assess the pathophysiological and clinical relevance of a simplified method for monitoring of PB suitable to be self‐managed by the patient at home. Methods and results A night‐time respiratory recording was performed in 397 optimally treated HF patients (age 60 ± 11 years, NYHA class 2.4 ± 0.6, left ventricular ejection fraction 29 ± 7%) and the duration of PB (PB Dur ) automatically computed. Patients were followed‐up for 1 year and the prognostic value of PB Dur evaluated. In 45 patients, we assessed the association between PB Dur and severity of oxygen desaturations (number of desaturations >3%). Twenty six of the 397 patients died of cardiac causes. A PB Dur ≥2 h was significantly associated with an increased risk of cardiac death after adjustment for major clinical predictors [hazard ratio (95% CI): 3.5 (1.6–7.9), P = 0.002]. The correlation between PB Dur and severity of desaturations was 0.94 ( P < 0.0001). Conclusion Relevant pathophysiological and clinical information can be obtained from simplified monitoring of breathing disorders managed by the patient. These results provide new perspectives in the investigation of the clinical impact of abnormal breathing in HF patients.