Search

Introduction: Sleep-disordered breathing (SDB) has been associated with increased risk of adverse events in patients with heart failure (HF). However, the impact of SDB on patients with left ventricular assist device (LVAD) remains unclear. Methods: We prospectively enrolled 50 patients with HeartMateII who were examined their respiratory disturbance index (RDI) by portable sleep monitoring. The patients were divided into 2 groups, SDB (RDI>15, n=12) and no-SDB (RDI<15, n=38), based on the existence of moderate SDB, or not. The patients were followed-up for the occurrence of adverse events (arrhythmia, cerebrovascular, hemolysis, bleeding, infection, and death) after enrollment. Results: There were no significant differences between 2 groups in gender, body mass index, etiology of cardiac disease, medical therapy. In addition, there were no significant difference between 2 groups in echocardiographic and hemodynamic parameters. Age [53±4 vs 42±2 , p=0.02], Brain natriuretic peptide [324 (132-627) pg/ml vs 88 (51-185) pg/ml, p=0.009] and eGFR [60±27 ml/min vs 86±31 ml/min, p=0.01] were higher in Group SDB than Group no-SDB. The prevalence of VTa after enrollment was higher in Group SDB during follow-up period; 160±70 days [4 (33%)vs 2 (5%), p=0.02]. On Cox proportional hazard analysis, the presence of SDB was a significant predictor (Hazard ratio 6.5, 95% confidence interval 1.28-47.19, p=0.03) for VTa. The patients with VTa in Group no-SDB had occurred once VTa event. The patients in Group SDB developed multiple VTa events which required both repeated cardioversion and various anti-arrhythmic medical therapies. Conclusions: Some patients with HF still have SDB even after LVAD implantation. The result of this study suggested that SBD in patients with LVAD is associated with the occurrence of VTa. Neurohumoral hyperactivation due to SBD may trigger the VTa and some interventions to SBD may be effective to suppress VTa in patients with LVAD. [ABSTRACT FROM AUTHOR]