Key result
In patients with acute heart failure, significant sleep apnea (REI ≥15/h) was associated with higher 24-hour and nighttime blood pressure (p<0.05) and greater nocturnal ventricular ectopy (p=0.0098).
Why the study?
To investigate the influence of sleep apnea on ECG and blood pressure monitoring parameters in patients with acute heart failure.
Does significant sleep apnea influence 24-hour and nocturnal ECG and blood pressure parameters in patients with acute heart failure?
Observational (n=51)
Does significant sleep apnea influence 24-hour and nocturnal ECG and blood pressure parameters in patients with acute heart failure?
Significant sleep apnea in stabilized acute heart failure patients is associated with higher blood pressure, blunted circadian BP variation, and increased nocturnal ventricular ectopy.
May warrant sleep apnea evaluation in acute HF; hypothesis-generating for treatment effects on BP or ectopy.
OBJECTIVE: To investigate the influence of sleep apnea (SA) on ECG and blood pressure (BP) monitoring parameters in patients with acute heart failure (AHF). METHODS: A total of 51 hospitalized patients with AHF (13 women, 38 men, mean age 60.8 years) underwent 24-hour combined monitoring of ECG and BP and SA testing before discharge. Heart rhythm (mean heart rate, arrhythmias, pauses, QT interval, heart rate variability) and BP (mean systolic and diastolic values, variability, circadian variation) parameters were obtained for the whole day and for nighttime (22: 00-06: 00). Depending on SA severity, the patients were divided into two groups (respiratory event index, REI, < 15/h and ≥15/h). Comparisons of parameters between the two groups were performed using t test and χ2 test (alpha < 0.05 for significance). RESULTS: A total of 29 (56.9%) patients had REI ≥15/h. In this group, the systolic and diastolic BP values (24-hour and nighttime) were significantly higher (p < 0.05). BP variability did not differ, and a markedly blunted circadian variation of both the systolic and diastolic values was observed. In the group with REI ≥15/h, we found a higher nocturnal versus diurnal mean heart rate ratio (p = 0.046) and a greater occurrence of nocturnal versus diurnal ventricular premature beats (p = 0.0098). CONCLUSION: The presence of significant SA was found to influence the BP values and nocturnal ventricular ectopy in patients with stabilized AHF. SA, 24-hour ECG, and BP monitoring could provide important information with potential impact on patient management.
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Frigy et al. (2018) conducted an observational in Acute heart failure (n=51). Sleep apnea (REI ≥15/h) vs. REI < 15/h was evaluated on 24-hour and nocturnal ECG and blood pressure parameters. In patients with acute heart failure, significant sleep apnea (REI ≥15/h) was associated with higher 24-hour and nighttime blood pressure (p<0.05) and greater nocturnal ventricular ectopy (p=0.0098).
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