The Occurence And Clinical Characteristics Of Sleep Apnea In Heart Failure Patients With Atrial Fibrillation

ObjectiveThe relationship between heart failure (HF), sleep-disordered breathing and cardiac arrhythmias is complex and poorly understood. The purpose of this study is to evaluate the occurence and clinical characteristics of sleep apnea syndrome (SAS) in heart failure (HF) patients with atrial fibrillation (AF).MethodsFrom HF patients hospitalized in The First Affiliated Hospital of Nanjing Medical University during June of 2012 to June of 2014, Based on electrocardiography examination, patients were recruited including 110 patients with AF (coexisting AF group) and 105 parallel control patients without AF but with matched age, gender and body mass index (simple HF group). Comparison was made about the occurence and characteristics of SAS between two groups.ResultsThere was no statistical difference in causes of HF, complications, New York Heart Association class and basic medication between two groups. Compared with the patients in simple HF group, the patients in coexisting AF group had a significantly higher Epworth sleepiness scale score, larger cardiothoracic ratio (10.1±5.8 vs 8.2±5.5,0.63±0.08 vs 0.57±0.07; both P<0.05), and shorter 6-minute walk distance [(305±70) vs (335±69) m, P<0.05]. There was no difference in left ventricular ejection fraction, left ventricular end-diastolic dimension and left ventricular end-systolic dimension between two groups. However, left atrial diameter was remarkably larger in coexisting AF group than that in simple HF group (P<0.05). The prevalence of SAS was higher in coexisting AF group than that in simple HF group (36.4% vs 20.0%, P<0.05). Compared with simple HF group, the coexisting AF group had a higher apnea/hypopnea index [4(1,16) vs 3(1,7) times/h, P<0.05]. No significant differences was detected between two groups among the rapid of eye movement sleep stage/total sleep time, arousal index, mean and lowest pulse oxygen saturation (SpO2) and oxygen desaturation index.ConclusionsHF patients with AF have a higher frequency of SAS, maily central sleep apnea, more severe daytime sleepiness and poorer physical activity than age-matched simple HF patients without AF.