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Impact of sleep-disordered breathing and efficacy of positive airway pressure on mortality in patients with chronic heart failure and sleep-disordered breathing: a meta-analysis.
Clin Res Cardiol 2015; 104(3):208-16CR

Abstract

BACKGROUNDS

To conduct a meta-analysis to investigate whether sleep-disordered breathing (SDB) is an independent risk factor for mortality and whether positive airway pressure (PAP) decreases mortality in patients with chronic heart failure (HF). The impact of SDB and the effects of PAP on mortality in patients with chronic HF remain unclear.

METHODS

We searched the MEDLINE, EMBASE, and Cochrane databases. Clinical trials that addressed mortality and the effect of PAP on mortality in chronic HF patients with SDB were included in this meta-analysis.

RESULTS

Eleven studies (1,944 participants in total) that addressed mortality in chronic HF patients with SDB were included in this study. Patients with SDB showed a significantly increased mortality risk compared to those without SDB [risk ratio (RR) 1.66 (1.19-2.31)]. In sub-analyses, a significant increase in risk of mortality was observed for central sleep apnea versus no-SDB [RR 1.48 (1.15-1.91)], whereas no significant increase in risk was observed for obstructive sleep apnea versus no-SDB. Five randomized controlled studies (395 participants) that assessed the effect of PAP in chronic HF patients with SDB were analyzed. Adaptive servo-ventilation (ASV) significantly reduced all-cause mortality in chronic HF patients with SDB [RR 0.13 (0.02-0.95)], whereas continuous PAP did not significantly reduce all-cause mortality [RR 0.71 (0.32-1.57)].

CONCLUSIONS

The prevalence of SDB in patients with chronic HF is associated with worse survival, and ASV reduces all-cause mortality in patients with chronic HF concomitant with SDB.

Authors+Show Affiliations

Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-Ku, Tokyo, 113-0022, Japan, s-nakamura@nms.ac.jp.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review

Language

eng

PubMed ID

25336356

Citation

Nakamura, Shunichi, et al. "Impact of Sleep-disordered Breathing and Efficacy of Positive Airway Pressure On Mortality in Patients With Chronic Heart Failure and Sleep-disordered Breathing: a Meta-analysis." Clinical Research in Cardiology : Official Journal of the German Cardiac Society, vol. 104, no. 3, 2015, pp. 208-16.
Nakamura S, Asai K, Kubota Y, et al. Impact of sleep-disordered breathing and efficacy of positive airway pressure on mortality in patients with chronic heart failure and sleep-disordered breathing: a meta-analysis. Clin Res Cardiol. 2015;104(3):208-16.
Nakamura, S., Asai, K., Kubota, Y., Murai, K., Takano, H., Tsukada, Y. T., & Shimizu, W. (2015). Impact of sleep-disordered breathing and efficacy of positive airway pressure on mortality in patients with chronic heart failure and sleep-disordered breathing: a meta-analysis. Clinical Research in Cardiology : Official Journal of the German Cardiac Society, 104(3), pp. 208-16. doi:10.1007/s00392-014-0774-3.
Nakamura S, et al. Impact of Sleep-disordered Breathing and Efficacy of Positive Airway Pressure On Mortality in Patients With Chronic Heart Failure and Sleep-disordered Breathing: a Meta-analysis. Clin Res Cardiol. 2015;104(3):208-16. PubMed PMID: 25336356.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of sleep-disordered breathing and efficacy of positive airway pressure on mortality in patients with chronic heart failure and sleep-disordered breathing: a meta-analysis. AU - Nakamura,Shunichi, AU - Asai,Kuniya, AU - Kubota,Yoshiaki, AU - Murai,Koji, AU - Takano,Hitoshi, AU - Tsukada,Yayoi Tetsuou, AU - Shimizu,Wataru, Y1 - 2014/10/22/ PY - 2014/08/06/received PY - 2014/10/14/accepted PY - 2014/10/23/entrez PY - 2014/10/23/pubmed PY - 2015/12/15/medline SP - 208 EP - 16 JF - Clinical research in cardiology : official journal of the German Cardiac Society JO - Clin Res Cardiol VL - 104 IS - 3 N2 - BACKGROUNDS: To conduct a meta-analysis to investigate whether sleep-disordered breathing (SDB) is an independent risk factor for mortality and whether positive airway pressure (PAP) decreases mortality in patients with chronic heart failure (HF). The impact of SDB and the effects of PAP on mortality in patients with chronic HF remain unclear. METHODS: We searched the MEDLINE, EMBASE, and Cochrane databases. Clinical trials that addressed mortality and the effect of PAP on mortality in chronic HF patients with SDB were included in this meta-analysis. RESULTS: Eleven studies (1,944 participants in total) that addressed mortality in chronic HF patients with SDB were included in this study. Patients with SDB showed a significantly increased mortality risk compared to those without SDB [risk ratio (RR) 1.66 (1.19-2.31)]. In sub-analyses, a significant increase in risk of mortality was observed for central sleep apnea versus no-SDB [RR 1.48 (1.15-1.91)], whereas no significant increase in risk was observed for obstructive sleep apnea versus no-SDB. Five randomized controlled studies (395 participants) that assessed the effect of PAP in chronic HF patients with SDB were analyzed. Adaptive servo-ventilation (ASV) significantly reduced all-cause mortality in chronic HF patients with SDB [RR 0.13 (0.02-0.95)], whereas continuous PAP did not significantly reduce all-cause mortality [RR 0.71 (0.32-1.57)]. CONCLUSIONS: The prevalence of SDB in patients with chronic HF is associated with worse survival, and ASV reduces all-cause mortality in patients with chronic HF concomitant with SDB. SN - 1861-0692 UR - https://www.unboundmedicine.com/medline/citation/25336356/Impact_of_sleep_disordered_breathing_and_efficacy_of_positive_airway_pressure_on_mortality_in_patients_with_chronic_heart_failure_and_sleep_disordered_breathing:_a_meta_analysis_ L2 - https://dx.doi.org/10.1007/s00392-014-0774-3 DB - PRIME DP - Unbound Medicine ER -