Cheyne-Stokes respiration and obstructive sleep apnoea are independent risk factors for malignant ventricular arrhythmias requiring appropriate cardioverter-defibrillator therapies in patients with congestive heart failure
The aim of this first large-scale long-term study was to investigate whether obstructive sleep apnoea (OSA) and/or central sleep apnoea (CSA) are associated with an increased risk of malignant cardiac arrhythmias in patients with congestive heart failure (CHF). Of 472 CHF patients who were screened...
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Veröffentlicht in: | European heart journal 2011, Vol.32 (1), p.61-74 |
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description | The aim of this first large-scale long-term study was to investigate whether obstructive sleep apnoea (OSA) and/or central sleep apnoea (CSA) are associated with an increased risk of malignant cardiac arrhythmias in patients with congestive heart failure (CHF).
Of 472 CHF patients who were screened for sleep disordered breathing (SDB) 6 months after implantation of a cardiac resynchronization device with cardioverter-defibrillator, 283 remained untreated [170 with mild or no sleep disordered breathing (mnSDB) and 113 patients declined ventilation therapy] and were included into this study. During follow-up (48 months), data on appropriately monitored ventricular arrhythmias as well as appropriate cardioverter-defibrillator therapies were obtained from 255 of these patients (90.1%). Time period to first monitored ventricular arrhythmias and to first appropriate cardioverter-defibrillator therapy were significantly shorter in patients with either CSA or OSA. Forward stepwise Cox models revealed an independent correlation for CSA and OSA regarding monitored ventricular arrhythmias [apnoea-hypopnoea index (AHI) ≥5 h(-1): CSA HR 2.15, 95% CI 1.40-3.30, P < 0.001; OSA HR 1.69, 95% CI 1.64-1.75, P = 0.001; AHI ≥15 h(-1): CSA HR 2.06, 95% CI 1.40-3.05, P < 0.001; OSA HR 1.69, 95% CI 1.14-2.51, P = 0.02] and appropriate cardioverter-defibrillator therapies (AHI ≥5 h(-1): CSA HR 3.24, 95% CI 1.86-5.64, P < 0.001; OSA HR 2.07, 95% CI 1.14-3.77, P = 0.02; AHI ≥15 h(-1): CSA HR 3.41, 95% CI 2.10-5.54, P < 0.001; OSA HR 2.10, 95% CI 1.17-3.78, P = 0.01).
In patients with CHF, CSA and OSA are independently associated with an increased risk for ventricular arrhythmias and appropriate cardioverter-defibrillator therapies. |
doi_str_mv | 10.1093/eurheartj/ehq327 |
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Of 472 CHF patients who were screened for sleep disordered breathing (SDB) 6 months after implantation of a cardiac resynchronization device with cardioverter-defibrillator, 283 remained untreated [170 with mild or no sleep disordered breathing (mnSDB) and 113 patients declined ventilation therapy] and were included into this study. During follow-up (48 months), data on appropriately monitored ventricular arrhythmias as well as appropriate cardioverter-defibrillator therapies were obtained from 255 of these patients (90.1%). Time period to first monitored ventricular arrhythmias and to first appropriate cardioverter-defibrillator therapy were significantly shorter in patients with either CSA or OSA. Forward stepwise Cox models revealed an independent correlation for CSA and OSA regarding monitored ventricular arrhythmias [apnoea-hypopnoea index (AHI) ≥5 h(-1): CSA HR 2.15, 95% CI 1.40-3.30, P < 0.001; OSA HR 1.69, 95% CI 1.64-1.75, P = 0.001; AHI ≥15 h(-1): CSA HR 2.06, 95% CI 1.40-3.05, P < 0.001; OSA HR 1.69, 95% CI 1.14-2.51, P = 0.02] and appropriate cardioverter-defibrillator therapies (AHI ≥5 h(-1): CSA HR 3.24, 95% CI 1.86-5.64, P < 0.001; OSA HR 2.07, 95% CI 1.14-3.77, P = 0.02; AHI ≥15 h(-1): CSA HR 3.41, 95% CI 2.10-5.54, P < 0.001; OSA HR 2.10, 95% CI 1.17-3.78, P = 0.01).
In patients with CHF, CSA and OSA are independently associated with an increased risk for ventricular arrhythmias and appropriate cardioverter-defibrillator therapies.</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/eurheartj/ehq327</identifier><identifier>PMID: 20846992</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Aged ; Arrhythmias, Cardiac - complications ; Biological and medical sciences ; Cardiac dysrhythmias ; Cardiology. Vascular system ; Cheyne-Stokes Respiration - etiology ; Defibrillators, Implantable - statistics & numerical data ; Disease-Free Survival ; Echocardiography ; Exercise Test ; Female ; Heart ; Heart Failure - complications ; Heart failure, cardiogenic pulmonary edema, cardiac enlargement ; Humans ; Kaplan-Meier Estimate ; Male ; Medical sciences ; Middle Aged ; Pneumology ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Respiratory system : syndromes and miscellaneous diseases ; Risk Factors ; Sleep Apnea, Obstructive - etiology</subject><ispartof>European heart journal, 2011, Vol.32 (1), p.61-74</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c300t-2afdba3e318d0a0a321beac052ea770e33b82b8922e4845a422d9710e025f9463</citedby><cites>FETCH-LOGICAL-c300t-2afdba3e318d0a0a321beac052ea770e33b82b8922e4845a422d9710e025f9463</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,4024,27923,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23861782$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20846992$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>BITTER, Thomas</creatorcontrib><creatorcontrib>WESTERHEIDE, Nina</creatorcontrib><creatorcontrib>PRINZ, Christian</creatorcontrib><creatorcontrib>SAJID HOSSAIN, Mohamed</creatorcontrib><creatorcontrib>VOGT, Jürgen</creatorcontrib><creatorcontrib>LANGER, Christoph</creatorcontrib><creatorcontrib>HORSTKOTTE, Dieter</creatorcontrib><creatorcontrib>OLDENBURG, Olaf</creatorcontrib><title>Cheyne-Stokes respiration and obstructive sleep apnoea are independent risk factors for malignant ventricular arrhythmias requiring appropriate cardioverter-defibrillator therapies in patients with congestive heart failure</title><title>European heart journal</title><addtitle>Eur Heart J</addtitle><description>The aim of this first large-scale long-term study was to investigate whether obstructive sleep apnoea (OSA) and/or central sleep apnoea (CSA) are associated with an increased risk of malignant cardiac arrhythmias in patients with congestive heart failure (CHF).
Of 472 CHF patients who were screened for sleep disordered breathing (SDB) 6 months after implantation of a cardiac resynchronization device with cardioverter-defibrillator, 283 remained untreated [170 with mild or no sleep disordered breathing (mnSDB) and 113 patients declined ventilation therapy] and were included into this study. During follow-up (48 months), data on appropriately monitored ventricular arrhythmias as well as appropriate cardioverter-defibrillator therapies were obtained from 255 of these patients (90.1%). Time period to first monitored ventricular arrhythmias and to first appropriate cardioverter-defibrillator therapy were significantly shorter in patients with either CSA or OSA. Forward stepwise Cox models revealed an independent correlation for CSA and OSA regarding monitored ventricular arrhythmias [apnoea-hypopnoea index (AHI) ≥5 h(-1): CSA HR 2.15, 95% CI 1.40-3.30, P < 0.001; OSA HR 1.69, 95% CI 1.64-1.75, P = 0.001; AHI ≥15 h(-1): CSA HR 2.06, 95% CI 1.40-3.05, P < 0.001; OSA HR 1.69, 95% CI 1.14-2.51, P = 0.02] and appropriate cardioverter-defibrillator therapies (AHI ≥5 h(-1): CSA HR 3.24, 95% CI 1.86-5.64, P < 0.001; OSA HR 2.07, 95% CI 1.14-3.77, P = 0.02; AHI ≥15 h(-1): CSA HR 3.41, 95% CI 2.10-5.54, P < 0.001; OSA HR 2.10, 95% CI 1.17-3.78, P = 0.01).
In patients with CHF, CSA and OSA are independently associated with an increased risk for ventricular arrhythmias and appropriate cardioverter-defibrillator therapies.</description><subject>Aged</subject><subject>Arrhythmias, Cardiac - complications</subject><subject>Biological and medical sciences</subject><subject>Cardiac dysrhythmias</subject><subject>Cardiology. Vascular system</subject><subject>Cheyne-Stokes Respiration - etiology</subject><subject>Defibrillators, Implantable - statistics & numerical data</subject><subject>Disease-Free Survival</subject><subject>Echocardiography</subject><subject>Exercise Test</subject><subject>Female</subject><subject>Heart</subject><subject>Heart Failure - complications</subject><subject>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pneumology</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Respiratory system : syndromes and miscellaneous diseases</subject><subject>Risk Factors</subject><subject>Sleep Apnea, Obstructive - etiology</subject><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkU9v1DAQxSMEotvCnRPyBXEKdez8PaIVUKRKHACJWzRxJptpEzs7dhbtl-Wz4HaXcrEP897zb_yS5E0mP2Sy0de48ojA4e4ax71W1bNkkxVKpU2ZF8-TjcyaIi3L-tdFcun9nZSyLrPyZXKhZJ2XTaM2yZ_tiEeL6ffg7tELRr8QQyBnBdheuM4HXk2gAwo_IS4CFusQBDAKsj0uGA8bBJO_FwOY4NiLwbGYYaKdhTg6xDmTWSfgaOPxGMaZ4OGt_UpMdhczF3YLEwQUBrgnd0AOyGmPA3VM0wQxV4QRGRaKmGTFEiFjsBe_KYzCOLtD_4j5-CERhaaV8VXyYoDJ4-vzfZX8_Pzpx_Ymvf325ev2421qtJQhVTD0HWjUWd1LkKBV1iEYWSiEqpKodVerrm6UwrzOC8iV6psqkyhVMTR5qa-S96fcuMh-jSTtTN5gBLfoVt_WSulSF0UTlfKkNOy8ZxzauPgMfGwz2T6U2j6V2p5KjZa35_C1m7F_MvxrMQrenQXgDUwDgzXk_-t0rL2qlf4Lg4S3MA</recordid><startdate>2011</startdate><enddate>2011</enddate><creator>BITTER, Thomas</creator><creator>WESTERHEIDE, Nina</creator><creator>PRINZ, Christian</creator><creator>SAJID HOSSAIN, Mohamed</creator><creator>VOGT, Jürgen</creator><creator>LANGER, Christoph</creator><creator>HORSTKOTTE, Dieter</creator><creator>OLDENBURG, Olaf</creator><general>Oxford University Press</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2011</creationdate><title>Cheyne-Stokes respiration and obstructive sleep apnoea are independent risk factors for malignant ventricular arrhythmias requiring appropriate cardioverter-defibrillator therapies in patients with congestive heart failure</title><author>BITTER, Thomas ; WESTERHEIDE, Nina ; PRINZ, Christian ; SAJID HOSSAIN, Mohamed ; VOGT, Jürgen ; LANGER, Christoph ; HORSTKOTTE, Dieter ; OLDENBURG, Olaf</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c300t-2afdba3e318d0a0a321beac052ea770e33b82b8922e4845a422d9710e025f9463</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Aged</topic><topic>Arrhythmias, Cardiac - complications</topic><topic>Biological and medical sciences</topic><topic>Cardiac dysrhythmias</topic><topic>Cardiology. Vascular system</topic><topic>Cheyne-Stokes Respiration - etiology</topic><topic>Defibrillators, Implantable - statistics & numerical data</topic><topic>Disease-Free Survival</topic><topic>Echocardiography</topic><topic>Exercise Test</topic><topic>Female</topic><topic>Heart</topic><topic>Heart Failure - complications</topic><topic>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pneumology</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Respiratory system : syndromes and miscellaneous diseases</topic><topic>Risk Factors</topic><topic>Sleep Apnea, Obstructive - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>BITTER, Thomas</creatorcontrib><creatorcontrib>WESTERHEIDE, Nina</creatorcontrib><creatorcontrib>PRINZ, Christian</creatorcontrib><creatorcontrib>SAJID HOSSAIN, Mohamed</creatorcontrib><creatorcontrib>VOGT, Jürgen</creatorcontrib><creatorcontrib>LANGER, Christoph</creatorcontrib><creatorcontrib>HORSTKOTTE, Dieter</creatorcontrib><creatorcontrib>OLDENBURG, Olaf</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>BITTER, Thomas</au><au>WESTERHEIDE, Nina</au><au>PRINZ, Christian</au><au>SAJID HOSSAIN, Mohamed</au><au>VOGT, Jürgen</au><au>LANGER, Christoph</au><au>HORSTKOTTE, Dieter</au><au>OLDENBURG, Olaf</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cheyne-Stokes respiration and obstructive sleep apnoea are independent risk factors for malignant ventricular arrhythmias requiring appropriate cardioverter-defibrillator therapies in patients with congestive heart failure</atitle><jtitle>European heart journal</jtitle><addtitle>Eur Heart J</addtitle><date>2011</date><risdate>2011</risdate><volume>32</volume><issue>1</issue><spage>61</spage><epage>74</epage><pages>61-74</pages><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract>The aim of this first large-scale long-term study was to investigate whether obstructive sleep apnoea (OSA) and/or central sleep apnoea (CSA) are associated with an increased risk of malignant cardiac arrhythmias in patients with congestive heart failure (CHF).
Of 472 CHF patients who were screened for sleep disordered breathing (SDB) 6 months after implantation of a cardiac resynchronization device with cardioverter-defibrillator, 283 remained untreated [170 with mild or no sleep disordered breathing (mnSDB) and 113 patients declined ventilation therapy] and were included into this study. During follow-up (48 months), data on appropriately monitored ventricular arrhythmias as well as appropriate cardioverter-defibrillator therapies were obtained from 255 of these patients (90.1%). Time period to first monitored ventricular arrhythmias and to first appropriate cardioverter-defibrillator therapy were significantly shorter in patients with either CSA or OSA. Forward stepwise Cox models revealed an independent correlation for CSA and OSA regarding monitored ventricular arrhythmias [apnoea-hypopnoea index (AHI) ≥5 h(-1): CSA HR 2.15, 95% CI 1.40-3.30, P < 0.001; OSA HR 1.69, 95% CI 1.64-1.75, P = 0.001; AHI ≥15 h(-1): CSA HR 2.06, 95% CI 1.40-3.05, P < 0.001; OSA HR 1.69, 95% CI 1.14-2.51, P = 0.02] and appropriate cardioverter-defibrillator therapies (AHI ≥5 h(-1): CSA HR 3.24, 95% CI 1.86-5.64, P < 0.001; OSA HR 2.07, 95% CI 1.14-3.77, P = 0.02; AHI ≥15 h(-1): CSA HR 3.41, 95% CI 2.10-5.54, P < 0.001; OSA HR 2.10, 95% CI 1.17-3.78, P = 0.01).
In patients with CHF, CSA and OSA are independently associated with an increased risk for ventricular arrhythmias and appropriate cardioverter-defibrillator therapies.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>20846992</pmid><doi>10.1093/eurheartj/ehq327</doi><tpages>14</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Aged Arrhythmias, Cardiac - complications Biological and medical sciences Cardiac dysrhythmias Cardiology. Vascular system Cheyne-Stokes Respiration - etiology Defibrillators, Implantable - statistics & numerical data Disease-Free Survival Echocardiography Exercise Test Female Heart Heart Failure - complications Heart failure, cardiogenic pulmonary edema, cardiac enlargement Humans Kaplan-Meier Estimate Male Medical sciences Middle Aged Pneumology Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Respiratory system : syndromes and miscellaneous diseases Risk Factors Sleep Apnea, Obstructive - etiology |
title | Cheyne-Stokes respiration and obstructive sleep apnoea are independent risk factors for malignant ventricular arrhythmias requiring appropriate cardioverter-defibrillator therapies in patients with congestive heart failure |
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