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The reduction of central sleep apnoea severity in the left lateral position is not due to an improvement in cardiac haemodynamics in patients with chronic heart failure
- Source :
- Sleep medicine. 34
- Publication Year :
- 2016
-
Abstract
- Objective The severity of central sleep apnoea (CSA), a common comorbidity in patients with chronic heart failure (CHF) and reduced ejection fraction, markedly decreases from the supine to the lateral sleeping position, with no difference between the left and right positions. The mechanisms responsible for this beneficial effect have not yet been elucidated. Methods We tested the hypothesis that CSA attenuation in the left lateral position is due, at least in part, to an improvement in cardiac haemodynamics. Sixteen CHF patients (male, aged 60 ± 7 years, New York Heart Association class 2.6 ± 0.5, left ventricular ejection fraction [LVEF] 30% ± 5%) with moderate-to-severe CSA underwent two consecutive tissue Doppler echocardiography examinations in random order, one in the left lateral position (90°) and the other in the supine position (0°). The following parameters were obtained: left ventricular end-diastolic volume (LVEDV) and LVEF, left atrial volume (LAV) and right atrial volume (RAV), mitral regurgitation (MR), cardiac output (CO), transmitral protodiastolic (E) wave deceleration time (DT), E/e′ ratio, tricuspid annular plane systolic excursion (TAPSE), and right ventricular−atrial gradient (RVAG). Results The LAV, MR, E/e′, RAV, and RVAG significantly increased, whereas the LVEF and TAPSE significantly decreased in the left lateral position. All changes, however, were of negligible clinical significance. No significant changes were observed in CO, DT, and LVEDV. Conclusions This study shows that the reduction of CSA severity from the supine to the left lateral position in patients with CHF is not due to an improvement in cardiac haemodynamics. Other, noncardiac factors are likely to represent the main cause.
- Subjects :
- Male
medicine.medical_specialty
Cardiac output
Supine position
Polysomnography
Posture
Hemodynamics
Comorbidity
030204 cardiovascular system & hematology
Severity of Illness Index
Ventricular Function, Left
03 medical and health sciences
0302 clinical medicine
Tissue Doppler echocardiography
Internal medicine
Medicine
Humans
Clinical significance
cardiovascular diseases
Prospective Studies
Heart Failure
Mitral regurgitation
Ejection fraction
business.industry
General Medicine
Middle Aged
medicine.disease
Sleep Apnea, Central
030228 respiratory system
Echocardiography
Heart failure
Anesthesia
Chronic Disease
cardiovascular system
Cardiology
business
Sleep
Subjects
Details
- ISSN :
- 18785506
- Volume :
- 34
- Database :
- OpenAIRE
- Journal :
- Sleep medicine
- Accession number :
- edsair.doi.dedup.....28410f4aeb466c23b8bf34a179aaf7f8