Nocturnal periodic breathing is an independent predictor of cardiac death and multiple hospital admissions in Heart failure

We assessed the association of periodic breathing (PB) with mortality and hospital re-admissions in a large sample of patients enrolled in the European Community study HHH (Home or Hospital in Heart failure). A 24-hour cardiorespiratory recording was carried out in 443 clinically stable heart failure (HF) subjects (age: 60+11 years, NYHA class 2.4+0.6, LVEF 29+7%). We computed the apnoea/hypopnea index (AHI, events/hour) and the duration of PB (hours) during night-time and tested their association with total cardiac death (Cox regression) and hospitalization for worsening HF (logistic regression). All analysis were multivariate adjusting for known clinical/functional risk factors. AHI and PB duration were independent predictors of cardiac death (p<0.02 both) and of recurrent (ges 2) hospital re- admissions (p=0.04 and 0.003 respectively). This study confirms the independent predictive value of PB and provides evidence that PB is associated with a higher risk of multiple hospital re-admissions.