PMID- 18575711
OWN - NLM
STAT- MEDLINE
DCOM- 20081104
LR  - 20190606
IS  - 1414-431X (Electronic)
IS  - 0100-879X (Linking)
VI  - 41
IP  - 3
DP  - 2008 Mar
TI  - Breathing disorders in congestive heart failure: gender, etiology and mortality.
PG  - 215-22
AB  - We investigated the relationship between sleep-disordered breathing (SDB) and 
      Cheyne-Stokes respiration (CSR) while awake as well as mortality. Eighty-nine 
      consecutive outpatients (29 females) with congestive heart failure (CHF; left 
      ventricular ejection fraction, LVEF <45%) were prospectively evaluated. The 
      presence of SDB and of CSR while awake before sleep onset was investigated by 
      polysomnography. SDB prevalence was 81 and 56%, using apnea-hypopnea index 
      cutoffs >5 and >15, respectively. CHF etiologies were similar according to the 
      prevalence of SDB and sleep pattern. Males and females were similar in age, body 
      mass index, and LVEF. Males presented more SDB (P = 0.01), higher apnea-hypopnea 
      index (P = 0.04), more light sleep (stages 1 and 2; P < 0.05), and less deep 
      sleep (P < 0.001) than females. During follow-up (25 +/- 10 months), 27% of the 
      population died. Non-survivors had lower LVEF (P = 0.01), worse New York Heart 
      Association (NYHA) functional classification (P = 0.03), and higher CSR while 
      awake (P < 0.001) than survivors. As determined by Cox proportional model, NYHA 
      class IV (RR = 3.95, 95%CI = 1.37-11.38, P = 0.011) and CSR while awake with a 
      marginal significance (RR = 2.96, 95%CI = 0.94-9.33, P = 0.064) were associated 
      with mortality. In conclusion, the prevalence of SDB and sleep pattern of 
      patients with Chagas' disease were similar to that of patients with CHF due to 
      other etiologies. Males presented more frequent and more severe SDB and worse 
      sleep quality than females. The presence of CSR while awake, but not during 
      sleep, may be associated with a poor prognosis in patients with CHF.
FAU - Silva, R S
AU  - Silva RS
AD  - Laboratorio do Sono, Faculdade de Medicina, Universidade de Sao Paulo, Brasil.
FAU - Figueiredo, A C
AU  - Figueiredo AC
FAU - Mady, C
AU  - Mady C
FAU - Lorenzi-Filho, G
AU  - Lorenzi-Filho G
LA  - eng
PT  - Journal Article
PL  - Brazil
TA  - Braz J Med Biol Res
JT  - Brazilian journal of medical and biological research = Revista brasileira de 
      pesquisas medicas e biologicas
JID - 8112917
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Chagas Cardiomyopathy/complications/*mortality
MH  - Cheyne-Stokes Respiration/etiology/*mortality
MH  - Epidemiologic Methods
MH  - Female
MH  - Heart Failure/complications/*mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Polysomnography
MH  - Prognosis
MH  - Sleep Apnea Syndromes/etiology/*mortality
EDAT- 2008/06/26 09:00
MHDA- 2008/11/05 09:00
CRDT- 2008/06/26 09:00
PHST- 2007/07/24 00:00 [received]
PHST- 2008/01/25 00:00 [accepted]
PHST- 2008/06/26 09:00 [pubmed]
PHST- 2008/11/05 09:00 [medline]
PHST- 2008/06/26 09:00 [entrez]
AID - S0100-879X2008000300007 [pii]
AID - 10.1590/s0100-879x2008000300007 [doi]
PST - ppublish
SO  - Braz J Med Biol Res. 2008 Mar;41(3):215-22. doi: 10.1590/s0100-879x2008000300007.