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Sleep Apnea May Increase Risk of Heart Failure Death

Study shows risk of death doubles for heart failure patients with central sleep apnea

WEDNESDAY, May 16 (HealthDay News) -- A number of factors are associated with an increased risk of death in patients with systolic heart failure, including central sleep apnea, right ventricular systolic dysfunction and low diastolic blood pressure, researchers report in the May 22 issue of the Journal of the American College of Cardiology.

Shahrokh Javaheri, M.D., of the Veterans Affairs Medical Center in Cincinnati, Ohio, and colleagues followed 88 patients with systolic heart failure (defined by a left ventricular ejection fraction of 45 percent or less) for an average of 51 months to determine if central sleep apnea increases mortality for heart failure patients. The average age of patients was 62 years for those with an apnea-hypopnea index (AHI) of less than 5 per hour and 67 years for those with an AHI of 5 or greater per hour.

The mean AHI for patients with sleep apnea was 34 per hour compared to 2 per hour for those without. Survival of patients with sleep apnea was approximately 45 months compared to 90 months for those without sleep apnea, resulting in a hazard ratio for death of 2.14. Low diastolic blood pressure and right ventricular systolic dysfunction also contributed to poor survival.

The authors emphasize that the link between sleep apnea and mortality in this group remained high, even after adjustment for strong confounders of heart failure including left ventricular ejection fraction, New York Heart Association functional class, and age, among others. The question remains as to "whether the effective treatment of central sleep apnea is associated with improved survival" in patients with heart failure," the authors note.

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