Implications of Cheyne-Stokes breathing in advanced systolic heart failure

Abstract

Background: Cheyne-Stokes breathing (CSB) has been associated with heart failure (HF) patients for many years; however, its true prevalence and its prognostic implications are still obscure.

Hypothesis: The goal of this study was to investigate the prevalence and the possible prognostic implications of nocturnal CSB in advanced heart failure patients.

Methods: We performed single night full polysomonography ambulatory sleep studies in 71 HF patients. We analyzed the patients' sleep studies, clinical and laboratory data, and 6 month mortality.

Results: A total of 71 chronic systolic HF patients were analyzed, 60 males, 11 females, age 65 +/- 13 years. Mean left ventricular ejection fraction was 27% +/- 11%. Short episodes of CSB (at least 3 min duration) were present in all patients, and mean CSB duration was 1 hour. CSB duration was associated significantly with both high serum levels of N-terminal prohormone brain natriuretic peptide (NT-proBNP) as well as with 6 month mortality. Log CSB time had a significant correlation with log NT-proBNP (r = 0.5, P<.0001). Based on median CSB duration, the Kaplan-Meier survival curve analysis showed significant association with 6 month mortality (P = .03).

Conclusions: CSB prevalence in advanced HF patients is higher than previously reported and is associated with increased serum levels of NT-proBNP and higher 6 month mortality.