<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_pneum-2019-0002_s_006_w2aab3b7b2b1b6b1aab1c16b1Aa"><h3>Background</h3><p>Patients with sleep apnea syndrome (SAS) and heart failure (HF) have concomitant different comorbidities and increased risk of morbidity.</p></sec><sec id="j_pneum-2019-0002_s_007_w2aab3b7b2b1b6b1aab1c16b2Aa"><h3>Aim</h3><p>The aim of this study was to analyze differences between patients with SAS and heart failure with preserved ejection fraction (HFpEF; ejection fraction [EF]≥50%) – group 1 and those with SAS and heart failure with reduced ejection fraction (HFrEF; EF&lt;50%) – group 2.</p></sec><sec id="j_pneum-2019-0002_s_008_w2aab3b7b2b1b6b1aab1c16b3Aa"><h3>Methods</h3><p>We evaluated 51 patients with SAS and HF in the sleep laboratory of Timisoara Victor Babes Hospital. We collected general data, sleep questionnaires, anthropometric measurements (neck circumference [NC], abdominal circumference [AC]), somnography for apnea–hypopnea index (AHI), oxygen desaturation index (ODI), echocardiographic data, comorbidities, and laboratory test.</p></sec><sec id="j_pneum-2019-0002_s_009_w2aab3b7b2b1b6b1aab1c16b4Aa"><h3>Results</h3><p>The study included 51 patients who were divided into two groups depending on EF, with the following characteristics: Group 1 (HFpEF): 26 patients, 19 males, seven females, age 61.54±9.1 years, body mass index (BMI) 37±6.4 kg/m<sup>2</sup>, NC 45.4±3.6 cm, AC 126.6±12.9 cm, AHI 48.3±22.6 events/hour, central apnea 5.6±11.4 events/hour, obstructive apnea 25.7±18.7 events/hour, ODI 41.2±21.2/hour and lowest SpO<sub>2</sub> –72.1±14%.</p><p>Group 2 (HFrEF): 25 patients, 18 males, seven females, age 63.6±8.8 years, BMI 37.9±7.5 kg/m<sup>2</sup>, NC 46±4.4 cm, AC 127.2±13.9 cm, AHI 46.4±21.7 events/hour, central apnea 4.6±8.3 events/hour, obstructive apnea 25.9±18.5 events/hour, ODI 44.8±27.1/hour and lowest SpO<sub>2</sub> –70.6±12.1%. Differences between groups regarding anthropometric and somnographic measurements and lipidic profile were not statistically significant.</p><p>Significant differences were observed regarding stroke (23% vs. 4%, p=0.04) in the group with HFpEF and regarding creatinine measurements (1.1±0.2 vs. 1.4±0.7, p=0.049), aortic insufficiency (11.5% vs. 36%, p=0.04) and tricuspid insufficiency (6.1% vs. 80%, p=0.01) in the group with HFrEF.</p></sec><sec id="j_pneum-2019-0002_s_010_w2aab3b7b2b1b6b1aab1c16b5Aa"><h3>Conclusions</h3><p>Patients with SAS and HFpEF have a higher risk of stroke. Patients with SAS and HFrEF have a significantly increased risk of developing a life-long chronic kidney disease and aortic and tricuspid insufficiency. These results may suggest pathogenic links between SAS and the mentioned comorbidities, and this may explain the higher mortality when this association is present.</p></sec></abstract>

BackgroundPatients with sleep apnea syndrome (SAS) and heart failure (HF) have concomitant different comorbidities and increased risk of morbidity.AimThe aim of this study was to analyze differences between patients with SAS and heart failure with preserved ejection fraction (HFpEF; ejection fraction [EF]≥50%) – group 1 and those with SAS and heart failure with reduced ejection fraction (HFrEF; EF<50%) – group 2.MethodsWe evaluated 51 patients with SAS and HF in the sleep laboratory of Timisoara Victor Babes Hospital. We collected general data, sleep questionnaires, anthropometric measurements (neck circumference [NC], abdominal circumference [AC]), somnography for apnea–hypopnea index (AHI), oxygen desaturation index (ODI), echocardiographic data, comorbidities, and laboratory test.ResultsThe study included 51 patients who were divided into two groups depending on EF, with the following characteristics: Group 1 (HFpEF): 26 patients, 19 males, seven females, age 61.54±9.1 years, body mass index (BMI) 37±6.4 kg/m2, NC 45.4±3.6 cm, AC 126.6±12.9 cm, AHI 48.3±22.6 events/hour, central apnea 5.6±11.4 events/hour, obstructive apnea 25.7±18.7 events/hour, ODI 41.2±21.2/hour and lowest SpO2 –72.1±14%.Group 2 (HFrEF): 25 patients, 18 males, seven females, age 63.6±8.8 years, BMI 37.9±7.5 kg/m2, NC 46±4.4 cm, AC 127.2±13.9 cm, AHI 46.4±21.7 events/hour, central apnea 4.6±8.3 events/hour, obstructive apnea 25.9±18.5 events/hour, ODI 44.8±27.1/hour and lowest SpO2 –70.6±12.1%. Differences between groups regarding anthropometric and somnographic measurements and lipidic profile were not statistically significant.Significant differences were observed regarding stroke (23% vs. 4%, p=0.04) in the group with HFpEF and regarding creatinine measurements (1.1±0.2 vs. 1.4±0.7, p=0.049), aortic insufficiency (11.5% vs. 36%, p=0.04) and tricuspid insufficiency (6.1% vs. 80%, p=0.01) in the group with HFrEF.ConclusionsPatients with SAS and HFpEF have a higher risk of stroke. Patients with SAS and HFrEF have a significantly increased risk of developing a life-long chronic kidney disease and aortic and tricuspid insufficiency. These results may suggest pathogenic links between SAS and the mentioned comorbidities, and this may explain the higher mortality when this association is present.

Risk for stroke and chronic kidney disease in patients with sleep apnea syndrome and heart failure with different ejection fractions

University of Medicine and Pharmacy “Dr. Victor Babes”

Pulmonology Department, CardioPrevent Foundation

Pneumologia

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Riscul de atac ischemic și boală cronică de rinichi la pacienții cu sindrom de apnee în somn și insuficiență cardiacă cu diferite fracții de ejecție

BackgroundPatients with sleep apnea syndrome (SAS) and heart failure (HF) have concomitant different comorbidities and increased risk of morbidity.AimThe aim...

Risk for stroke and chronic kidney disease in patients with sleep apnea syndrome and heart failure with different ejection fractions

Article Category: Original Papers

Published Online: Jul 02, 2019

Page range: 15 - 20

DOI: https://doi.org/10.2478/pneum-2019-0002

Keywords
sleep apnea, stroke, chronic kidney disease, heart failure

© 2019 Ardelean et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Risk for stroke and chronic kidney disease in patients with sleep apnea syndrome and heart failure with different ejection fractions

Article Category: Original Papers

Published Online: Jul 02, 2019

Page range: 15 - 20

DOI: https://doi.org/10.2478/pneum-2019-0002

Keywordssleep apnea, stroke, chronic kidney disease, heart failure

© 2019 Ardelean et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
sleep apnea, stroke, chronic kidney disease, heart failure