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Titolo:
High prevalence and persistence of sleep apnoea in patients referred for acute left ventricular failure and medically treated over 2 months
Autore:
Tremel, F; Pepin, JL; Veale, D; Wuyam, B; Siche, JP; Mallion, JM; Levy, P;
Indirizzi:
CHU Grenoble, Dept Cardiol, F-38043 Grenoble, France CHU Grenoble Grenoble France F-38043 t Cardiol, F-38043 Grenoble, France CHU Grenoble, Dept Resp Med, F-38043 Grenoble, France CHU Grenoble Grenoble France F-38043 Resp Med, F-38043 Grenoble, France CHU Grenoble, Sleep Lab, F-38043 Grenoble, France CHU Grenoble Grenoble France F-38043 Sleep Lab, F-38043 Grenoble, France
Titolo Testata:
EUROPEAN HEART JOURNAL
fascicolo: 16, volume: 20, anno: 1999,
pagine: 1201 - 1209
SICI:
0195-668X(199908)20:16<1201:HPAPOS>2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Soggetto:
CONGESTIVE-HEART-FAILURE; CHEYNE-STOKES RESPIRATION; EXERCISE OXYGEN-CONSUMPTION; APNEA SYNDROME; AMBULATORY PATIENTS; EJECTION FRACTION; ARRHYTHMIAS; MORTALITY; ABNORMALITIES; HYPERTENSION;
Keywords:
left ventricular failure; sleep apnoea; Cheyne-Stokes respiration;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
41
Recensione:
Indirizzi per estratti:
Indirizzo: Tremel, F CHU Grenoble, Dept Cardiol, BP 217 X, F-38043 Grenoble, France CHU Grenoble BP 217 X Grenoble France F-38043 Grenoble, France
Citazione:
F. Tremel et al., "High prevalence and persistence of sleep apnoea in patients referred for acute left ventricular failure and medically treated over 2 months", EUR HEART J, 20(16), 1999, pp. 1201-1209

Abstract

Aims Cardiac failure patients were studied systematically using polysomnography 1 month after recovering from acute pulmonary oedema, and again after2 months of optimal medical treatment for cardiac failure. Methods and Results This prospective study of consecutive patients was conducted in a cardiac care unit of a university hospital. Vo(2) measurements and left ventricular ejection fraction were recorded. Thirty-four patients,initially recruited with pulmonary oedema, improved after 1 month of medical treatment to NYHA. II or III. They were aged less than 75 years and had a left ventricular ejection fraction less than 45% at the time of inclusion. Age was 62 (9) years, body mass index=27 (5) kg. m(-2) and an ejection fraction=30 (10)%. Eighteen of the 34 patients (53%) had coronary artery disease. Twenty-eight of the 34 had sleep apnoea syndrome with an apnoea+hypopnoea index >15.h(-1) of sleep. Thus, the prevalence of sleep apnoea in this population was 82%. Twenty-one of 28 (75%) patients had central sleep apnoea and seven of 28 (25%) had obstructive sleep apnoea. Patients with centralsleep apnoea had a lower Pace, than those with obstructive sleep apnoea (33 (5) vs 37 (5) mmHg, P<0.005). Significant correlations were found betweenapnoea + hypopnoea index and peak exercise oxygen consumption (r= -0.73, P<0.01), and apnoea+hypopnoea index and Paco(2), (r= -0.42, P=0.03). When only central sleep apnoea patients were considered, a correlation between apnoea+hypopnoea index and left ventricular ejection fraction was also demonstrated (r= - 0.46, P<0.04). After 2 months of optimal medical treatment onlytwo patients (both with central sleep apnoea) showed improvement (apnoea+hypopnoea index <15.h(-1)). Conclusions We have demonstrated a high prevalence of sleep apnoea, which persisted after 2 months of medical treatment, in patients referred for acute left Ventricular failure. Central sleep apnoea can be considered a marker of the severity of congestive heart failure.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 27/11/20 alle ore 02:57:09