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Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
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Carvedilol reduces the severity of central sleep apnea in chronic heart failure

Akira Tamura1, Yoshiyuki Kawano, Junichi Kadota

  • 1Internal Medicine 2, Faculty of Medicine, Oita University, Yufu, Japan. akira@med.oita-u.ac.jp

Circulation Journal : Official Journal of the Japanese Circulation Society
|January 6, 2009
PubMed

Insights

Carvedilol treatment improved heart function and reduced central sleep apnea (CSA) severity in chronic heart failure (CHF) patients. However, obstructive sleep apnea events may increase after treatment.

Area of Science:

  • Cardiology
  • Sleep Medicine
  • Pharmacology

Background:

  • Central sleep apnea (CSA) is a concern in chronic heart failure (CHF) patients.
  • Carvedilol, a beta-blocker, is used for CHF management.
  • Potential benefits of carvedilol on CSA severity in CHF patients warrant investigation.

Purpose of the Study:

  • To prospectively evaluate the effect of carvedilol on CSA severity in CHF patients.
  • To assess changes in polysomnographic findings, left ventricular (LV) function, and brain natriuretic peptide (BNP) levels.

Main Methods:

  • 16 CHF patients with CSA (NYHA class II-III, LVEF <50%) received carvedilol for 6 months.
  • Polysomnography, LV ejection fraction, and plasma BNP levels were measured pre- and post-treatment.
  • Safety and tolerability of carvedilol were assessed.

Main Results:

  • Carvedilol treatment improved LV ejection fraction (32% to 45%, P<0.001) and reduced BNP levels (P=0.017).
  • Apnea-hypopnea index and central apnea index significantly decreased (P<0.001).
  • Obstructive apnea index showed a significant increase (P=0.04).

Conclusions:

  • Carvedilol effectively reduces CSA severity in CHF patients.
  • Treatment with carvedilol improves cardiac function and reduces CHF biomarkers.
  • A potential increase in obstructive sleep apnea events requires further monitoring.

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