Sleep Disordered Breathing in Hypertrophic Cardiomyopathy
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ORIGINAL ARTICLE
Sleep Disordered Breathing in Hypertrophic Cardiomyopathy Salma I. Patel1 · Fadi E. Shamoun2 · Heidi Esser2 · Sairam Parthasarathy1 · Michael J. Ackerman3 · Jeffrey B. Geske3 · Steve R. Ommen3 · William T. Love4 · Virend K. Somers3 · Anwar A. Chahal3,6 · Johan M. Bos3 · Stephen S. Cha5 · Steven J. Lester2 Received: 11 July 2019 / Revised: 21 October 2019 / Accepted: 21 November 2019 © Springer Nature Singapore Pte Ltd. 2019
Abstract Introduction There is a paucity of scientific knowledge regarding the presence and nature of sleep disordered breathing (SDB) amongst patients with hypertrophic cardiomyopathy (HCM). SDB may contribute to morbidity and mortality in patients with HCM. The goal of this study was to characterize SDB among HCM patients and evaluate treatment patterns of, and adherence to, positive airway pressure (PAP) therapies. An additional aim was to characterize if PAP therapy was associated with mortality in patients with HCM. Methods Retrospective review of consecutive adults with idiopathic HCM undergoing polysomnography (PSG) at the Mayo Clinic over a 10 year period. Type of PAP therapy and PAP adherence were obtained if PAP therapy was prescribed. Results Ninety-four patients with HCM underwent PSG (age 56.3 ± 12.4 years; 62 males, [66%]). Median follow-up was 6 years. Most patients (n = 75, 80%) had obstructive sleep apnea (OSA), followed by a combination of obstructive and central sleep apnea (n = 6; 6%), and central sleep apnea (n = 1; 1%). Twenty-four percent (n = 18) of patients with OSA had treatment emergent central sleep apnea. The rest (n = 12, 13%) had normal PSG studies. Continuous PAP (n = 60) was the most commonly prescribed PAP modality followed by adaptive servo-ventilation (ASV; n = 10). For those patients with known adherence (n = 43), adherence was greater than 4 h a night for greater than 70% of the days for a majority of patients (n = 36; 83%). Mortality was not associated with SDB, PAP treatment or PAP adherence over the 10 year period. Conclusions SDB is highly prevalent in patients with HCM. Continuous PAP therapy was the most common PAP therapy and PAP adherence was high. There was no association between SDB and mortality in this limited data set of patients with HCM. Keywords Hypertrophic cardiomyopathy · Sleep apnea · Obstructive sleep apnea · Central sleep apnea · Treatment emergent central sleep apnea
* Steven J. Lester [email protected] 1
University of Arizona, 1501 N Campbell Ave, Tucson, AZ 85724, USA
2
Department of Cardiovascular Diseases, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ 85259, USA
3
Department of Cardiovascular Diseases, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
4
Department of Internal Medicine, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ 85259, USA
5
Department of Research Biostatistics, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ 85259, USA
6
Mayo Graduate School of Biomedical Sciences, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
Abbreviations AHI Apnea–hypopnea index AS
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