{"id":"e982e7f2f2b7","type":"article","url":"https://hartvaat.nl/2017/09/12/centrale-apneus-gedurende-24-uur-en-prognose-bij-hartfalen/","title":"Centrale apneus gedurende 24 uur en prognose bij hartfalen","title_en":"Prognostic Significance of Central Apneas Throughout a 24-Hour Period in Patients With Heart Failure.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":["nt-probnp"],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2017.07.740","source_url":"https://doi.org/10.1016/j.jacc.2017.07.740","authors":["Michele Emdin","Gianluca Mirizzi","Alberto Giannoni","Roberta Poletti","Giovanni Iudice","Francesca Bramanti","Claudio Passino"],"significance":5,"published":"2017-09-12","source_date":"2017-09-12","image":"","kennis":["https://hartvaat.nl/kennis/diagnostiek/galectine-3-st2-hartfalen/"],"congress":"","summary_en":"This study showed that central apneas throughout a 24-hour period (not just during sleep) predict outcomes in heart failure, suggesting that daytime central apneas carry similar prognostic significance to nocturnal events.","created":"2026-07-03T10:26:53Z","updated":"2026-07-03T13:26:10Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie naar de prognostische betekenis van centrale slaapapneus over een volledig 24-uursperiode bij hartfalenpatiënten. Verfijning van de risicostratificatie bij slaapgerelateerde ademhalingsstoornissen.","abstract_original":"BACKGROUND: Large trials using noninvasive mechanical ventilation to treat central apnea (CA) occurring at night (\"sleep apnea\") in patients with systolic heart failure (HF) have failed to improve prognosis. The prevalence and prognostic value of CA during daytime and over an entire 24-h period are not well described. OBJECTIVES: This study evaluated the occurrence and prognostic significance of nighttime, daytime, and 24-h CA episodes in a large cohort of patients with systolic HF. METHODS: Consecutive patients receiving guideline-recommended treatment for HF (n = 525; left ventricular ejection fraction [LVEF] of 33 ± 9%; 66 ± 12 years of age; 77% males) underwent prospective evaluation, including 24-h respiratory recording, and were followed-up using cardiac mortality as an endpoint. RESULTS: The 24-h prevalence of predominant CAs (apnea/hypopnea index [AHI] ≥5 events/h, with CA of >50%) was 64.8% (nighttime: 69.1%; daytime: 57.0%), whereas the prevalence of predominant obstructive apneas (OA) was 12.8% (AHI ≥5 events/h with OAs >50%; nighttime: 14.7%; daytime: 5.9%). Episodes of CA were associated with neurohormonal activation, ventricular arrhythmic burden, and systolic/diastolic dysfunction (all p < 0.05). During a median 34-month follow-up (interquartile range [IQR]: 17 to 36 months), 50 cardiac deaths occurred. Nighttime, daytime, and 24-h moderate-to-severe CAs were associated with increased cardiac mortality (AHI of </≥15 events/h; log-rank: 6.6, 8.7, and 5.3, respectively; all p < 0.05; central apnea index [CAI] of </≥10 events/h; log-rank 8.9, 11.2, and 10.9, respectively; all p < 0.001). Age, B-type natriuretic peptide level, renal dysfunction, 24-h AHI, CAI, and time with oxygen saturation of <90% were independent predictors of outcome. CONCLUSIONS: In systolic HF patients, CAs occurred throughout a 24-h period and were associated with a neurohormonal activation, ventricular arrhythmic burden, and worse prognosis."}