Implications of cheyne-stokes breathing in advanced systolic heart failure

Background: Cheyne-Stokes breathing (CSB) has been associated with heart failure (HF) patients for many years; however, its true prevalence and its prognostic implications are still obscure. Hypothesis: The goal of this study was to investigate the prevalence and the possible prognostic implications of nocturnal CSB in advanced heart failure patients. Methods: We performed single night full polysomonography ambulatory sleep studies in 71 HF patients.We analyzed the patients' sleep studies, clinical and laboratory data, and 6 month mortality. Results: A total of 71 chronic systolic HF patients were analyzed, 60 males, 11 females, age 65±13 years. Mean left ventricular ejection fraction was 27%±11%. Short episodes of CSB (at least 3 min duration) were present in all patients,andmean CSB durationwas 1 hour. CSB durationwas associatedsignificantlywith both high serum levels of N-terminal prohormone brain natriuretic peptide (NT-proBNP) as well as with 6 month mortality. Log CSB time had a significant correlationwith log NT-proBNP (r = 0.5, P<.0001).Based onmedian CSB duration, the Kaplan-Meier survival curve analysis showed significant associationwith 6 monthmortality (P = .03). Conclusions: CSB prevalence in advanced HF patients is higher than previously reported and is associated with increased serumlevels of NT-proBNP and higher 6 month mortality.