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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
Sleep-disordered breathing in heart failure with normal left ventricular ejection fraction.
Thomas Bitter1, Lothar Faber, Detlef Hering
1Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Georgstasse 11, D-32545 Bad Oeynhausen, Germany. akohlstaedt@hdz-nrw.de
European Journal of Heart Failure
|May 27, 2009
Summary
Sleep-disordered breathing (SDB) is common in heart failure with preserved ejection fraction (HFpEF). Central sleep apnea (CSA) is linked to worse heart function, but its prognostic impact in HFpEF requires further study.
Area of Science:
- Cardiology
- Sleep Medicine
- Pulmonology
Background:
- Systolic heart failure (SHF) is known to have a high prevalence of sleep-disordered breathing (SDB).
- The occurrence and characteristics of SDB in heart failure with normal left ventricular ejection fraction (HFNEF) remain less understood.
Purpose of the Study:
- To determine the prevalence and types of SDB in patients diagnosed with HFNEF.
- To explore the relationship between SDB, particularly central sleep apnea (CSA), and cardiopulmonary function in HFNEF patients.
Main Methods:
- A cohort of 244 HFNEF patients underwent comprehensive assessments including polysomnography, echocardiography, cardiopulmonary exercise testing (CPX), and heart catheterization.
- SDB was defined by an apnea-hypopnea index (AHI) ≥ 5/h.
- Diastolic function, CPX performance, and various hemodynamic and biomarker data were analyzed in relation to SDB presence and type.
Main Results:
- SDB was prevalent in 69.3% of HFNEF patients, with 39.8% having obstructive sleep apnea (OSA) and 29.5% having CSA.
- A significant association was found between worsening diastolic dysfunction and increased prevalence of SDB, especially CSA.
- Patients with SDB exhibited poorer performance on CPX and the six-minute walk test, with CSA patients showing lower CO2 partial pressure and higher NT-proBNP and cardiac filling pressures.
Conclusions:
- Heart failure with preserved ejection fraction (HFpEF) exhibits a high prevalence of SDB.
- Similar to SHF, CSA in HFpEF is associated with more compromised cardiopulmonary function.
- The prognostic significance of SDB in HFpEF warrants further investigation.
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