Prospective Evaluation of Heart Failure Patients With Central Sleep Apnea

Study Overview
=================
Brief Summary
-----------------
Central sleep apnea (CSA) has been associated with increased mortality and primarily occurs in patients with heart failure (HF). The primary purpose of this study is to document the natural progression of moderate to severe CSA in heart failure patients.

Detailed Description
-----------------
This trial is a prospective, non-randomized observational study in heart failure patients with moderate to severe central sleep apnea (CSA).

Official Title
-----------------
Prospective Evaluation of Heart Failure Patients With Central Sleep Apnea

Conditions
-----------------
Central Sleep Apnea, Heart Failure

Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Subject is willing and able to comply with this protocol and has signed an IRB/MEC approved informed consent (as well as Privacy Protection Authorization in the United States) Age is greater than or equal to 18 years Known recent history of sleep disordered breathing of predominantly central origin, as evidenced by an overnight PSG with EEG and at least 4 hours of recording that was conducted within 60 days of enrollment and demonstrating the following characteristics: AHI greater than or equal to 20 greater than or equal to 50% of classified events of a central nature less than 20% of the total AHI comprised of obstructive apnea events Diagnosed chronic heart failure, with medications optimized and stable for at least 30 days prior to the screening PSG, or since the date of the earliest test used for baseline, whichever is longer. Optimal medications include: beta blockade, ACE-I or ARB and diuretics unless contraindicated or not considered medically necessary. Exclusion Criteria: Current or intended use of any mask-based therapy for central sleep apnea Baseline oxygen saturation less than or equal to 90% on a stable FiO2 Severe Chronic Obstructive Pulmonary Disease (COPD) (per GOLD classification system) History of cerebrovascular accident (CVA), myocardial infarction (MI), coronary artery bypass grafting (CABG) surgery, or percutaneous coronary intervention (PCI), or any cardiac ablation procedure within the 3 months prior to the study Unstable angina History of primary pulmonary hypertension Currently enrolled in a non-observational (ie, interventional) clinical study that could confound the results of this study If subject has an implanted cardiac resynchronization device (CRT), it must have been implanted at least 3 months before enrollment; any other device must have been implanted at least 30 days prior to enrollment Life expectancy of less than 6 months

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Observational patients<br>Heart Failure patients with moderate to severe central sleep apnea | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Apnea-hypopnea index and its components | The primary objective of the study is to determine the natural progression of central sleep apnea, using the apnea-hypopnea index (AHI) and its components evaluated at 6 months. | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Clinical status associated with sleep disordered breathing | Epworth Sleepiness Scale Subject Global Assessment Quality of life as measured by Minnesota Living with Heart Failure Questionnaire HF Clinical Composite Six-minute hall walk NYHA Functional Class Echocardiographic measures of structure and function Subject medications | 6 months | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Heart Failure, Central Sleep Apnea, Sleep Disordered Breathing, Cardiac Dysfunction