Heart Care Info - Heart Disease Prevention & Treatment

Left ventricle remodelling is associated with sleep‐disordered breathing in non‐ischaemic cardiopathy with systolic dysfunction

T DAMY, A PAULINO, L MARGARIT... - Journal of Sleep ..., 2011 - Wiley Online Library DAMY, T., PAULINO, A., MARGARIT, L., DROUOT, X., STOICA, M., VERMES, E., GUERET, P., ADNOT, S., DUBOIS RANDE, J.-L., D''ORTHO, M.-P. and HITTINGER, L.(2011), Left ventricle remodelling is associated with sleep-disordered breathing in non-ischaemic ...

Overnight polygraphy was performed in the cardiology ward within 48 h before or after the echo. If the apparatus was not available, patients were invited to do it as soon as possible [median (IQR) time between the two measurements 2 (0 37) days]. Polygraphy used a computerised data acquisition system (Embletta , Res Med, Saint Priest, France), which recorded oro nasal airflow from nasal pressure and mouth thermistance, chest and abdominal effort by inductance plethysmography, pulse oximetry, snoring, actimetry and body position. A questionnaire was completed relating to sleep quality and estimated sleep duration during this recording night, and the measure of the Epworth sleepiness scale was also collected. All recordings were scored manually by two scorers (M. S. and M. P. O.) blinded to the cardiac assessment. If disagreement was observed regarding the SDB pattern (central versus obstructive), the polygraphy was read again by both scorers together to reach an agreement. With regard to trace quality, we took into account only recordings with at least 4 h duration without any trace missing. According to international recommendations (Anonymous, 1999), apnoea was defined as a decrease greater than 80% in nasal airflow lasting more than 10 s, and hypopnoea as a decrease of at least 30% nasal airflow with at least 4% desaturation. The number of apnoea hypopnoea events per hour (apnoea hypopnoea index; AHI) was determined after exclusion of periods with movements, which were considered to be wake periods. The diagnostic of SDB was considered if the AHI was ≥5 h 1. We divided the subjects into four classes depending on their AHI: 30 (severe SDB). Apnoeas without chest or abdominal movements, with or without Cheyne Stokes respiration, were classified as CS As, and apnoeas with chest and abdominal movements as OS As. Hypopnoeas were considered obstructive when there was evidence of upper airway obstruction, such as snoring, paradoxical respiratory band movement or inspiratory flow limitation through the nasal cannula; central hypopnoea, by contrast, was associated with in phase respiratory movements and no evidence of inspiratory flow limitation. Sleep apnea syndrome (SAS) was considered central if more than 50% of apnoea/hypopnoea events were central; SAS was considered obstructive if more than 50% were obstructive.