Source: Circulation  |  Posted 8 years ago

Patients with heart failure and who have concurrent central sleep apnoea showed increased sympathetic nerve activity compared to subjects with obstructive symptoms or no apnoea.

Researchers from Alfred Hospital, Melbourne, Australia, enrolled 55 patients with congestive heart failure who underwent right heart catheterisation. The authors measured total body and cardiac norepinephrine spillover. Based on polysomnography, patients were stratified into those without apnoea, those with obstructive sleep apnoea and those with central sleep apnoea, containing 19, 15 and 21 subjects respectively.

Patients with central sleep apnoea showed higher total body and cardiac norepinephrine spillover as well as raised mean pulmonary artery pressure compared to those without apnoea or with obstructive symptoms. However, norepinephrine kinetics did not show clinically significant differences between the groups after researchers controlled for heart failure severity.

Further analysis suggested that mean pulmonary artery pressure showed independent correlations with total body and cardiac norepinephrine spillover. On the other hand, sleep apnoea severity did not show any relationship to markers of sympathetic nerve activity.

The authors concluded that among congestive heart failure patients, those with concurrent central sleep apnoea show increased total body and cardiac sympathetic nerve activity compared to those with obstructive or no apnoea. The changes seem to be associated severity of heart failure rather than apnoea.