Nocturnal periodic breathing is an independent predictor of cardiac death and multiple hospital admissions in heart failure
Pinna GD., Maestri R., Mortara A., Johnson P., Witkowski T., Ponikowski P., Andrews D., Capomolla S., La Rovere MT., Sleight P.
We assessed the association of periodic breathing (PB) with mortality and hospital re-admissions in a large sample of patients enrolled in the European Community study HHH (Home or Hospital in Heart failure). A 24-hour cardiorespiratory recording was carried out in 443 clinically stable heart failure (HF) subjects (age: 60±11 years, NYHA class 2.4±0.6, LVEF 29±7%). We computed the apnoea/hypopnea index (AHI, events/hour) and the duration of PB (hours) during night-time and tested their association with total cardiac death (Cox regression) and hospitalization for worsening HF (logistic regression). All analysis were multivariate adjusting for known clinical/functional risk factors. AHI and PB duration were independent predictors of cardiac death (p < 0.02 both) and of recurrent (≥ 2) hospital readmissions (p=0.04 and 0.003 respectively). This study confirms the independent predictive value of PB and provides evidence that PB is associated with a higher risk of multiple hospital re-admissions.