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Original ResearchSleep MedicineTiming of Nocturnal Ventricular Ectopy in Heart Failure Patients With Sleep Apnea
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Subjects
As part of an ongoing prospective epidemiologic study, all patients with HF who are newly referred to our HF clinic undergo overnight polysomnography. This protocol was approved by the University of Toronto Research Ethics Board, and subjects provided written informed consent before study entry. The inclusion criteria were as follows: (1) chronic HF (LV ejection fraction < 45%, as assessed by echocardiography) secondary to ischemic or nonischemic cardiomyopathy; (2) sinus rhythm on the ECG; (3)
Characteristics of the Subjects
Forty patients (20 subjects in each group) with HF met our inclusion criteria. The clinical and polysomnographic data are summarized in Tables 1 and 2, respectively. Patients had a moderate-to-severe degree of sleep apnea, as indicated by their AHI. Patients with OSA were younger and more obese than those with CSA. In all subjects, LV ejection fraction was moderately to severely depressed, and all subjects were receiving appropriate medical therapy for HF. Medical therapy for HF was similar in
Discussion
In a previous study,4 we observed that the frequency of VPBs was higher during hyperpnea than apnea in HF patients with CSA. The present findings confirm that observation. However, the timing of ventricular ectopy during sleep in HF patients with OSA had not been examined previously. In this study, we compared the timing of the occurrence of ventricular ectopy in HF patients with either CSA or OSA matched for LV ejection fraction, sex, and AHI. During stage 2 sleep in HF patients with OSA, we
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Supported by operating grant MOP-11607 from the Canadian Institutes of Health Research (CIHR). Dr. Ryan was supported by a research fellowship from the Toronto Rehabilitation Institute, Dr. Leung was supported by a Clinician Scientist Award from the CIHR, and Dr. Bradley was supported by a Senior Scientist Award from the CIHR.
The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.