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Sleep apnoea in severe aortic stenosis
  1. Christian Prinz,
  2. Thomas Bitter,
  3. Olaf Oldenburg,
  4. Lothar Faber,
  5. Dieter Horstkotte,
  6. Cornelia Piper
  1. Department of Cardiology, Heart and Diabetes Centre North-Rhine Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany
  1. Correspondence to Dr Christian Prinz, Department of Cardiology, Heart and Diabetes Centre North-Rhine Westphalia, Ruhr–University Bochum, Georgstrasse 11, Bad Oeynhausen D-32545, Germany; cchrprinz{at}aol.com

Abstract

Background There are as yet no data on the prevalence of sleep apnoea in patients with severe aortic stenosis (AS).

Aims To assess the occurrence, severity and clinical correlates of sleep apnoea in patients with AS.

Methods During a 4-month period in 2010, 67 patients were consecutively included in this study, 42 of which (19 men; mean±SD age 72±9 years) had severe AS (aortic valve opening area ≤1.0 cm2); all were investigated with cardiorespiratory polygraphy. Sleep apnoea was diagnosed if the apnoea–hypopnoea index (AHI) (median (lower quartile, upper quartile)) was ≥5/h. The control group of 25 patients matched for age, body mass index and sex had angiographic exclusion of coronary artery disease, regular left ventricular ejection fraction, and no valve disease.

Results Sleep apnoea was found in 30/42 patients with AS (71%; AHI=23/h (14/h, 36/h)). The severity was significantly greater in patients with severe AS than in the control group (AHI=12/h (8/h, 17/h)) (p<0.01). Half of the patients with sleep apnoea had obstructive sleep apnoea (OSA) (AHI=15/h (9/h, 28/h)), and half had central sleep apnoea (CSA) (AHI=25/h (18/h, 45/h)). New York Heart Association classification and severity of sleep apnoea correlated with η=0.5 (η2=0.3). The severity of CSA correlated with pulmonary artery pressure (r=0.7, p<0.01) and pulmonary capillary wedge pressure (r=0.7, p<0.01). Patients with AS and CSA had a lower Pco2 than those with OSA and those without sleep apnoea (p<0.01).

Conclusions Sleep apnoea is common in patients with severe AS. The severity of CSA correlates with pulmonary hypertension, which may suggest that myocardial adaptation is exhausting.

  • Sleep apnoea
  • aortic stenosis
  • secondary pulmonary hypertension
  • myocardial adaptation
  • sleep medicine
  • adult cardiology
  • valvular heart disease

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Footnotes

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the ethics committee of Ruhr-University Bochum, Germany.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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