Sleep Apnea May Not Be Closely Linked to Heart Failure Severity

More evidence needed to assess true relationship, according to study in Journal of Cardiac Failure

Philadelphia, PA, 6 May 2009 – Obstructive sleep apnea (OSA) and central sleep apnea (CSA) are not markedly decreased in heart failure (HF) patients managed with beta-blockers and spironolactone, reports a study in the March issue of Journal of Cardiac Failure, published by Elsevier. The study, “Prevalence and Physiological Predictors of Sleep Apnea in Patients with Heart Failure and Systolic Dysfunction,” was authored by Dai Yumino, Hanqiao Wang, John S. Floras, Gary E. Newton, Susanna Mak, Pimon Ruttanaumpawan, John D. Parker, and T. Douglas Bradley.

As heart failure is a major public health concern, it is important to identify treatable conditions that may occur alongside it. The high prevalence of OSA and CSA in patients with heart failure has been well recognized in recent years, but there is limited information about secular trends in its occurrence, despite important advances in the management of these patients since this phenomenon was recognized.

The study involved 218 heart failure patients with reduced ejection fraction (mean 24.7%) who underwent sleep studies between 1997 and 2004. Overall 47% had moderate to severe OSA or CSA. Both conditions were more prevalent in older age and in men. OSA was associated with greater body mass index, whereas CSA was associated with atrial fibrillation, hypocapnia, and diuretic use.

These findings may have important implications for care HF patients with a prevalence of OSA and CSA because effective treatment of these sleep-related breathing disorders may be beneficial in addition to treatment with beta-blockers and sprionlactone.

"This study reemphasizes the high prevalence of sleep apnea, but unfortunately shows that despite the improvements in medical therapy and associated improvements in outcomes, the prevalence of sleep apnea has not diminished,” commented Barry M. Massie, M.D., Editor-in-Chief of Journal of Cardiac Failure. “This may indicate that the severity of heart failure and the occurrence of sleep apnea are not closely linked, but that there are common risk factors for both, such as older age, male sex, and obesity.

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About Journal of Cardiac Failure
Journal of Cardiac Failure publishes original, peer-reviewed communications of scientific excellence and review articles on clinical research, basic human studies, animal studies, and bench research with potential clinical applications to heart failure—pathogenesis, etiology, epidemiology, pathophysiological mechanisms, assessment, prevention, and treatment. Journal of Cardiac Failure is the official journal of the Heart Failure Society of America and the Japanese Heart Failure Society. It has an Impact Factor of 3.067 (the highest among journals with a heart failure focus and 19th among all cardiovascular journals) and an Immediacy Factor of 1.306, the 7th among all cardiovascular journals.

About the Heart Failure Society of America
The Heart Failure Society of America (HFSA) is a nonprofit educational organization, founded in 1994 as the first organized association of heart failure experts. Today HFSA has over 1,700 members and provides a forum for all those interested in heart function, heart failure research and patient care. The Society also serves as a resource for governmental agencies (FDA, NIH, NHLBI, CMS). Additional information on HFSA can be found at www.hfsa.org.

About Elsevier

Elsevier is a world-leading provider of information solutions that enhance the performance of science, health, and technology professionals, empowering them to make better decisions, deliver better care, and sometimes make groundbreaking discoveries that advance the boundaries of knowledge and human progress. Elsevier provides web-based, digital solutions — among them ScienceDirect, Scopus, Elsevier Research Intelligence, and ClinicalKey — and publishes nearly 2,200 journals, including The Lancet and Cell, and over 25,000 book titles, including a number of iconic reference works.

The company is part of Reed Elsevier Group PLC, a world leading provider of professional information solutions in the Science, Medical, Legal and Risk and Business sectors, which is jointly owned by Reed Elsevier PLC and Reed Elsevier NV. The ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).

Media Contact:
Maureen Hunter
Elsevier
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m.hunter@elsevier.com