Short-term effects of cardiac resynchronization therapy on sleep-disordered breathing in patients with systolic heart failure

Tomas Kara, Miroslav Novak, Jiri Nykodym, Kevin A. Bybee, Jaroslav Meluzin, Marek Orban, Zuzana Novakova, Jolana Lipoldova, David L. Hayes, Miroslav Soucek, Jiri Vitovec, Virend Somers

Research output: Contribution to journalArticle

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Abstract

Objectives: We evaluated the short-term effect of cardiac resynchronization therapy (CRT) on sleep apnea in patients with systolic heart failure. Background: Sleep-disordered breathing is common in patients with left ventricular systolic dysfunction. Methods: Twelve patients (mean [± SE] age, 59.6 ± 7.8 years; mean left ventricular ejection fraction, 28.0 ± 2.8%) with an implanted atrial-synchronized biventricular pacemaker for the treatment of left ventricular systolic dysfunction were selected and studied. Each subject underwent polysomnography on 3 consecutive nights with CRT on the first night, CRT off the second night, and CRT on the third night. Echocardiography was performed prior to each polysomnogram. Results: The central sleep event index (ie, the number of central sleep apneas [CSAs] and hypopneas per hour of sleep) score was lower with CRT compared to that without CRT (mean central sleep event index score with CRT on, 6.9 ± 1.7 events per hour of sleep; mean central sleep event index score with CRT off, 14.3 ± 2.9 events per hour of sleep; mean central sleep event index score with CRT on, 8.1 ± 1.5 events per hour of sleep; p < 0.001). Similarly, the cumulative duration of central sleep events (the number of minutes per hour of sleep during CRT) was one half that observed without CRT (CRT on, 2.8 ± 0.7 min per hour of sleep; CRT OFF 6.2 ±1.2 min per hour of sleep; CRT ON 3.1 ± 0.7 min per hour of sleep; p < 0.001). There was a significant correlation between mitral regurgitant volume and central sleep event index on all three nights (r > 0.77; p < 0.01). Conclusions: CRT reduces CSA severity in the short term. This reduction correlated significantly with the CRT-mediated reduction of mitral regurgitation.

Original languageEnglish (US)
Pages (from-to)87-93
Number of pages7
JournalChest
Volume134
Issue number1
DOIs
StatePublished - Jul 2008

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Systolic Heart Failure
Cardiac Resynchronization Therapy
Sleep Apnea Syndromes
Sleep
Central Sleep Apnea
Left Ventricular Dysfunction
Polysomnography
Mitral Valve Insufficiency
Stroke Volume
Echocardiography

Keywords

  • Cardiac resynchronization
  • Mitral regnrgitalion
  • Sleep apnea

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Short-term effects of cardiac resynchronization therapy on sleep-disordered breathing in patients with systolic heart failure. / Kara, Tomas; Novak, Miroslav; Nykodym, Jiri; Bybee, Kevin A.; Meluzin, Jaroslav; Orban, Marek; Novakova, Zuzana; Lipoldova, Jolana; Hayes, David L.; Soucek, Miroslav; Vitovec, Jiri; Somers, Virend.

In: Chest, Vol. 134, No. 1, 07.2008, p. 87-93.

Research output: Contribution to journalArticle

Kara, T, Novak, M, Nykodym, J, Bybee, KA, Meluzin, J, Orban, M, Novakova, Z, Lipoldova, J, Hayes, DL, Soucek, M, Vitovec, J & Somers, V 2008, 'Short-term effects of cardiac resynchronization therapy on sleep-disordered breathing in patients with systolic heart failure', Chest, vol. 134, no. 1, pp. 87-93. https://doi.org/10.1378/chest.07-2832
Kara, Tomas ; Novak, Miroslav ; Nykodym, Jiri ; Bybee, Kevin A. ; Meluzin, Jaroslav ; Orban, Marek ; Novakova, Zuzana ; Lipoldova, Jolana ; Hayes, David L. ; Soucek, Miroslav ; Vitovec, Jiri ; Somers, Virend. / Short-term effects of cardiac resynchronization therapy on sleep-disordered breathing in patients with systolic heart failure. In: Chest. 2008 ; Vol. 134, No. 1. pp. 87-93.
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abstract = "Objectives: We evaluated the short-term effect of cardiac resynchronization therapy (CRT) on sleep apnea in patients with systolic heart failure. Background: Sleep-disordered breathing is common in patients with left ventricular systolic dysfunction. Methods: Twelve patients (mean [± SE] age, 59.6 ± 7.8 years; mean left ventricular ejection fraction, 28.0 ± 2.8{\%}) with an implanted atrial-synchronized biventricular pacemaker for the treatment of left ventricular systolic dysfunction were selected and studied. Each subject underwent polysomnography on 3 consecutive nights with CRT on the first night, CRT off the second night, and CRT on the third night. Echocardiography was performed prior to each polysomnogram. Results: The central sleep event index (ie, the number of central sleep apneas [CSAs] and hypopneas per hour of sleep) score was lower with CRT compared to that without CRT (mean central sleep event index score with CRT on, 6.9 ± 1.7 events per hour of sleep; mean central sleep event index score with CRT off, 14.3 ± 2.9 events per hour of sleep; mean central sleep event index score with CRT on, 8.1 ± 1.5 events per hour of sleep; p < 0.001). Similarly, the cumulative duration of central sleep events (the number of minutes per hour of sleep during CRT) was one half that observed without CRT (CRT on, 2.8 ± 0.7 min per hour of sleep; CRT OFF 6.2 ±1.2 min per hour of sleep; CRT ON 3.1 ± 0.7 min per hour of sleep; p < 0.001). There was a significant correlation between mitral regurgitant volume and central sleep event index on all three nights (r > 0.77; p < 0.01). Conclusions: CRT reduces CSA severity in the short term. This reduction correlated significantly with the CRT-mediated reduction of mitral regurgitation.",
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AU - Kara, Tomas

AU - Novak, Miroslav

AU - Nykodym, Jiri

AU - Bybee, Kevin A.

AU - Meluzin, Jaroslav

AU - Orban, Marek

AU - Novakova, Zuzana

AU - Lipoldova, Jolana

AU - Hayes, David L.

AU - Soucek, Miroslav

AU - Vitovec, Jiri

AU - Somers, Virend

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N2 - Objectives: We evaluated the short-term effect of cardiac resynchronization therapy (CRT) on sleep apnea in patients with systolic heart failure. Background: Sleep-disordered breathing is common in patients with left ventricular systolic dysfunction. Methods: Twelve patients (mean [± SE] age, 59.6 ± 7.8 years; mean left ventricular ejection fraction, 28.0 ± 2.8%) with an implanted atrial-synchronized biventricular pacemaker for the treatment of left ventricular systolic dysfunction were selected and studied. Each subject underwent polysomnography on 3 consecutive nights with CRT on the first night, CRT off the second night, and CRT on the third night. Echocardiography was performed prior to each polysomnogram. Results: The central sleep event index (ie, the number of central sleep apneas [CSAs] and hypopneas per hour of sleep) score was lower with CRT compared to that without CRT (mean central sleep event index score with CRT on, 6.9 ± 1.7 events per hour of sleep; mean central sleep event index score with CRT off, 14.3 ± 2.9 events per hour of sleep; mean central sleep event index score with CRT on, 8.1 ± 1.5 events per hour of sleep; p < 0.001). Similarly, the cumulative duration of central sleep events (the number of minutes per hour of sleep during CRT) was one half that observed without CRT (CRT on, 2.8 ± 0.7 min per hour of sleep; CRT OFF 6.2 ±1.2 min per hour of sleep; CRT ON 3.1 ± 0.7 min per hour of sleep; p < 0.001). There was a significant correlation between mitral regurgitant volume and central sleep event index on all three nights (r > 0.77; p < 0.01). Conclusions: CRT reduces CSA severity in the short term. This reduction correlated significantly with the CRT-mediated reduction of mitral regurgitation.

AB - Objectives: We evaluated the short-term effect of cardiac resynchronization therapy (CRT) on sleep apnea in patients with systolic heart failure. Background: Sleep-disordered breathing is common in patients with left ventricular systolic dysfunction. Methods: Twelve patients (mean [± SE] age, 59.6 ± 7.8 years; mean left ventricular ejection fraction, 28.0 ± 2.8%) with an implanted atrial-synchronized biventricular pacemaker for the treatment of left ventricular systolic dysfunction were selected and studied. Each subject underwent polysomnography on 3 consecutive nights with CRT on the first night, CRT off the second night, and CRT on the third night. Echocardiography was performed prior to each polysomnogram. Results: The central sleep event index (ie, the number of central sleep apneas [CSAs] and hypopneas per hour of sleep) score was lower with CRT compared to that without CRT (mean central sleep event index score with CRT on, 6.9 ± 1.7 events per hour of sleep; mean central sleep event index score with CRT off, 14.3 ± 2.9 events per hour of sleep; mean central sleep event index score with CRT on, 8.1 ± 1.5 events per hour of sleep; p < 0.001). Similarly, the cumulative duration of central sleep events (the number of minutes per hour of sleep during CRT) was one half that observed without CRT (CRT on, 2.8 ± 0.7 min per hour of sleep; CRT OFF 6.2 ±1.2 min per hour of sleep; CRT ON 3.1 ± 0.7 min per hour of sleep; p < 0.001). There was a significant correlation between mitral regurgitant volume and central sleep event index on all three nights (r > 0.77; p < 0.01). Conclusions: CRT reduces CSA severity in the short term. This reduction correlated significantly with the CRT-mediated reduction of mitral regurgitation.

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