Heart failure and sleep related breathing disorders: Data from PROMISES (Progetto Multicentrico Italiano Sonno e Scompenso Cardiaco) study

Una visione più approfondita delle caratteristiche dei disturbi respiratori legati al sonno e dei suoi determinanti nei pazienti con scompenso cardiaco, per una migliore gestione clinica. (Int J Cardiol 2018 Nov 15)

21 September Sep 2018 2 months ago
  • Contini M, Agostoni P

In heart failure (HF) sleep problems and sleep-related breathing disorders are frequently reported and are associated with poor prognosis. However, only few large clinical studies have investigated this issue in heart failure through breathing pattern analysis by polysomnography.

The possible determinants of sleep related breathing disorders were analyzed through stepwise logistic regression analysis and two multivariate models showing that a markedly reduced left ventricular ejection fraction was the most important factor associated with central sleep apneas (OR = 7.7 for AHI cutoff = 15 and LVEF ≤ 35%) together with male gender and increasing age. Conventional risk factors for obstructive sleep apnea did not identify HF patients affected by this condition. Conversely, a greater neck circumference was associated with an increased risk for central apneas.

The data from this paper offer a deeper insight into the features of sleep-related breathing disorders and its determinants in HF patients, leading in turn to a better clinical management of these comorbid patients.


Reference
1. Lombardi C, Faini A, La Rovere M, Fanfulla F, Mattaliano P, Caravita S, Contini M, Agostoni P, Perrone-Filardi P, Parati G; PROMISES Investigators. Heart failure and sleep related breathing disorders: Data from PROMISES (Progetto Multicentrico Italiano Sonno e Scompenso Cardiaco) study. Int J Cardiol 2018 Nov 15;271:140-145. doi: 10.1016/j.ijcard.2018.05.001. Go to PubMed