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(Chest. 2007;131:130-135.)
© 2007 American College of Chest Physicians

Relationship Between ß-Blocker Treatment and the Severity of Central Sleep Apnea in Chronic Heart Failure*

Akira Tamura, MD; Yoshiyuki Kawano, MD; Shigeru Naono, MD; Munenori Kotoku, MD and Jun-ichi Kadota, MD, PhD

* From the Second Department of Internal Medicine, Faculty of Medicine, Oita University, Oita, Japan.

Correspondence to: Akira Tamura, MD, Second Department of Internal Medicine, Faculty of Medicine, Oita University, Hasama, Yufu, Oita 879-5593, Japan; e-mail: akira{at}med.oita-u.ac.jp

Abstract

Background: We sought to examine the relationship between use of ß-blockers and the severity of central sleep apnea (CSA) in patients with chronic heart failure.

Methods: We performed polysomnography in 45 patients with chronic heart failure (New York Heart Association functional class II/III and left ventricular ejection fraction < 50%) and examined the relationship between use of ß-blockers and the severity of CSA. Central apnea index (CAI) was used as an indicator of CSA.

Results: Patients receiving ß-blockers (ie, carvedilol; n = 27) had lower apnea-hypopnea index (AHI) and CAI than patients not receiving ß-blockers (n = 18) [mean ± SD, 14 ± 11 vs 33 ± 17, p < 0.0001; and 1.9 ± 3.2 vs 11 ± 12, p = 0.0004, respectively]. AHI and CAI were negatively correlated with the dose of carvedilol (Spearman {rho} = – 0.61, p < 0.0001; and Spearman {rho} = – 0.57, p = 0.0002, respectively). Multiple regression analysis selected no use of ß-blockers as an independent factor of CAI (p = 0.0006). In five patients with CAI > 5 who underwent serial sleep studies, CAI decreased significantly after 6 months of treatment with carvedilol (9.5 ± 4.9 to 1.3 ± 2.4, p = 0.03).

Conclusions: In patients with chronic heart failure, CAI was lower according to the dose of ß-blockers, and no use of ß-blockers was independently associated with CAI. In addition, 6 months of treatment with carvedilol decreased CAI. These results suggest that ß-blocker therapy may dose-dependently suppress CSA in patients with chronic heart failure.

Key Words: ß-blocker • central sleep apnea • chronic heart failure




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