Association of serious adverse events with Cheyne–Stokes respiration characteristics in patients with systolic heart failure and central sleep apnoea: A SERVE-Heart Failure substudy analysis

Faizan Javed, Renaud Tamisier, Jean Louis Pepin, Martin R. Cowie, Karl Wegscheider, Christiane Angermann, Marie Pia d'Ortho, Erland Erdmann, Anita K. Simonds, Virend K. Somers, Helmut Teschler, Patrick Levy, Jeff Armitstead, Holger Woehrle

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Background and objective: Increases in Cheyne–Stokes respiration (CSR) cycle length (CL), lung-to-periphery circulation time (LPCT) and time to peak flow (TTPF) may reflect impaired cardiac function. This retrospective analysis used an automatic algorithm to evaluate baseline CSR-related features and then determined whether these could be used to identify patients with systolic heart failure (HF) who experienced serious adverse events in the Treatment of Sleep-Disordered Breathing with Predominant Central Sleep Apnea by Adaptive Servo Ventilation in Patients with Heart Failure (SERVE-HF) substudy. Methods: A total of 280 patients had overnight diagnostic polysomnography data available; an automated algorithm was applied to quantify CSR-related features. Results: Median baseline CL, LPCT and TTPF were similar in the control (n = 152) and adaptive servo-ventilation (ASV, n = 156) groups. In both groups, CSR-related features were significantly longer in patients who did (n = 129) versus did not (n = 140) experience a primary endpoint event (all-cause death, life-saving cardiovascular intervention or unplanned hospitalization for worsening HF): CL, 61.1 versus 55.1 s (P = 0.002); LPCT, 36.5 versus 31.5 s (P < 0.001); TTPF, 15.20 versus 13.35 s (P < 0.001), respectively. This finding was independent of treatment allocation. Conclusion: Patients with systolic HF and central sleep apnoea who experienced serious adverse events had longer CSR CL, LPCT and TTPF. Future studies should examine an independent role for CSR-related features to enable risk stratification in systolic HF.

Original languageEnglish (US)
Pages (from-to)305-311
Number of pages7
JournalRespirology
Volume25
Issue number3
DOIs
StatePublished - Mar 1 2020

Keywords

  • Cheyne–Stokes respiration
  • adaptive servo-ventilation
  • central sleep apnoea
  • heart failure with reduced ejection fraction
  • mortality

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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