2003 OPEN FORUM Abstracts
CLINICAL VALUATION OF CHEYNE-STOKES RESPIRATION DURING SLEEP IN PATIENTS WITH CHRONIC HEART FAILURE
GUO Xiheng, Chen W, Hongyu Z, Weimin K, Li A, Li L, Xinzhi W
Beijing Chaoyang Hospital-Beijing Institute of Respiratory Medicine
Affiliated Capital University of Medical Sciences
Beijing 100020, P.R. China
Introductions: Nocturnal Cheyne-Stokes respiration (CSR) occurs frequently in patients with chronic heart failure (CHF), and it may be associated with sympathetic activation. The aim of the present study was to evaluate whether CSR could affect prognosis in patients with CHF.
Methods: 110 CHF patients with left ventricular ejection fraction ≤35%, in NYHA class II to III, underwent a nocturnal polysomnogram study to evaluate the sleep stages, CSR index(CSRI), and apnea/hypopnea index (AHI) and oxygen desaturation.
RESULTS: CSR occurred in 76 CHF patients during sleep among study group. The NYHA functional class of CHF patients with CSR were higher than those of patients without CSR. The more CSR they have, the severer left ventricular ejection fraction depressed, the larger left and right atria and the severer oxygen desaturation. Patients with higher CSRI spent a greater percentage of the night in periodic breathing with decreased SWS and REMS. CSRI≥ 20/h could be identified as the independent and additional predictors of very high risk for fatal outcome for patients with CHF.
Conclusions: CSR is common in patient with CHF. They usually suffer poorer sleep quality and severer oxygen desaturation and more serious left ventricular ejection fraction depression than patients without evident CSR . CSRI ≥ 20/h is a main independent predictor of very high risk in clinical stable patients with CHF.