Journal of Southern Medical University

Journal of Southern Medical University ›› 2021, Vol. 41 ›› Issue (9): 1415-1419.doi: 10.12122/j.issn.1673-4254.2021.09.18

Previous Articles     Next Articles

Objective sleep characteristics and risk factors for sleep apnea in heart failure patients with different left ventricular ejection fraction

HAN Binbin, WANG Shanshan, LI Guohua, WANG Xuehui, CHEN Zhigang, ZHAO Guoan, CHEN Yingen, LI Meng, LI Yan, ZHANG Min, AI Sizhi   

  1. Department of Cardiology, Heart Center, First Affiliated Hospital of Xinxiang Medical University, Weihui 453100, China; King's College London British Heart Foundation Centre of Research Excellence, School of Cardiovascular Medicine & Sciences, London SE59NU, UK
  • Online:2021-09-20 Published:2021-09-30

RichHTML

36

PDF

513

Abstract: Objective To investigate the objective sleep characteristics and the independent risk factors for sleep apnea in heart failure (HF) patients with different left ventricular ejection fractions (LVEF). Methods A total of 107 patients with chronic HF hospitalized in the Department of Cardiology of our hospital from April, 2019 to October, 2020 were included in this study. According to the LVEF measured by echocardiography, the patients were divided into reduced ejection fraction (HFrEF) group (n=35), mid-range ejection fraction (HFmrEF) group (n=21), and preserved ejection fraction (HFpEF) group (n=51). The baseline demographic and clinical characteristics of the patients were recorded. To assess the objective sleep characteristics, whole night polysomnography was scheduled for all the patients. Spearman correlation and multinomial logistic regression analyses were used to explore the factors affecting objective sleep characteristics. Results The patients in HFpEF group had significantly lower proportion of non-rapid eye movement sleep stage 1, apnea hypopnea index (AHI), and central sleep apnea (CSA) than those in HFrEF group (all P<0.05). The baseline demographic data or sleep structures in HFmrEF group did not differ significantly from those in the other two groups. Spearman correlation analysis revealed significant correlations of the male sex, diuretics use, NT-proBNP, LVEF, and total cholesterol levels with the severity of AHI (all P<0.05). After adjusting for potential confounders, multiple logistics regression analysis showed that age, drinking, and LVEF levels were independently associated with the severity of AHI (all P<0.05). Conclusion Abnormal objective sleep architectures occur in all HF patients, manifested mainly by sleep apnea. The incidences of sleep apnea and CSA are lower in patients with HFpEF than in those with HFrEF. Age, drinking, and LVEF levels are independent risk factors for the occurrence and severity of sleep apnea.

Key words: left ventricular ejection fraction; heart failure; sleep apnea; apnea hypopnea index