Prevalence and persistence of breathing disorders in chronic heart failure patients: preliminary results from home telemonitoring in the HHH study

In this paper we present preliminary results of the European Community multicountry trial HHH (Home or Hospital in Heart Failure), which assessed the prevalence and persistence of nocturnal breathing disorders in mild-to-moderate CHF patients. All subjects (465) carried out a baseline respiratory recording in the hospital, followed by 12 recordings (one per month) at home. The latter were totally self-managed by the patients, and data were transmitted to the referring hospital through telephone lines. We found that 43% of the patients had a periodic breathing pattern (PB, waxing and waning of ventilation with or without apneas) during the night lasting >1 hour, and the apnea-hypopnea index (AHI) was >5 events/hour in 51% of them. During the 1-year follow-up, a PB>1 hour and an AHI>5 events/hour were persistent (i.e., occurred in >50% of the recordings) in 43% and 52% of the patients. These findings confirm the high prevalence of nocturnal breathing disorders in CHF patients and show that in a large proportion of patients they tend to persist over time