BACKGROUND: Sleep disordered @entity1353 (SDB) is common in @entity1 with @entity712 with reduced ejection fraction (HFrEF). An increased @entity27 index (AHI) is associated with poor outcomes. We examined whether an analysis of nocturnal desaturations (NDs) can improve the risk stratification. METHODS: Three-hundred seventy-six consecutive @entity1 with stable chronic HFrEF and LVEF  <=45% were prospectively screened using polygraphy. @entity387 ( @entity387 ) was defined as an AHI >= 15. The mean age was 59  13years, the mean LVEF was 30  6%, and the median AHI was 18 [IQR: 9.33). The composite end-point of death, heart transplantation or LV assistance occurred in 98 @entity1 (26%) within 3years. Minimal @entity26 saturation (MOS) during sleep, the number of desaturations <90%/h and the time spent with @entity26 saturation <90% were significantly associated with adverse events (adjusted HR 1.25 [1.03-1.52], 1.25 [1.03-1.53], and 1.28 [1.04-1.59]), whereas the AHI was not (1.10 [0.86-1.39]). The best MOS cut-off value for poor outcomes was  <=88%. The @entity1 with an MOS  <=88% had a significantly higher event rate (31.9%) than those with an MOS >88% (15.6%; p<0.01). The risk assessment using an MOS of  <=88% in addition to established prognostic markers yielded a net reclassification index (NRI) of nearly 6% and was particularly useful in the subgroup of @entity1 with events (NRI: 8.4%). CONCLUSIONS: In HFrEF @entity1 , @entity11702  <=88% appears to be predictive of adverse events, independent of the presence of @entity387 . This suggests that the risk assessment in HFrEF should also include @entity11702 in top of AHI.

Apnea- XXXX and desaturations in @entity712 with reduced ejection fraction: Are we aiming at the right target?

@entity1 :: ('9606', 'Species') :: ['patients'] @entity712 :: ('MESH:D006333', 'Disease') :: ['heart failure'] @entity387 :: ('MESH:D012891', 'Disease') :: ['Sleep apnea', 'SA'] @entity1353 :: ('MESH:D004417', 'Disease') :: ['breathing'] @entity26 :: ('MESH:D010100', 'Chemical') :: ['oxygen'] @entity27 :: ('MESH:D020181', 'Disease') :: ['apnea-hypopnea'] @entity11702 :: ('MESH:C537849', 'Disease') :: ['ND']
@entity387 :: (MESH:D012891,Disease) :: ['hypopnea']
