Clinical InvestigationSix-Month Aerobic Exercise Training Ameliorates Central Sleep Apnea in Patients With Chronic Heart Failure
Section snippets
Patients
We studied 18 patients (17 men and 1 woman) with symptomatic (New York Heart Association functional Class II or III), chronic heart failure and SDB (apnea-hypopnea index [AHI] of >10). All patients had left ventricular systolic dysfunction (left ventricular ejection fraction <45%), were in a clinically stable condition for at least 1 month, and were free of pulmonary or peripheral edema. No patient had been treated with continuous positive airway pressure or had ever participated in cardiac
Control Group
In the control group, there was no difference in body mass index (25.7 [24.4–27.2] versus 25.5 [23.7–25.9]) or plasma BNP concentrations (177.8 [161.5–241.7] pg/mL versus 158.1 [92.2–202.6] pg/mL) in 6-month intervals. There was no significant difference in AHI between the 2 sleep studies (30.4 [19.9–36.3] versus 36.6 [8.6–39.4], Fig. 1A). Furthermore, the numbers per night of central apnea and obstructive apnea/hypopnea in these patients were comparable between the 2 examinations (158.5
Discussion
SDB, especially central sleep apnea, is common in heart failure patients and is an independent predictor of poor prognosis.2, 3, 4 Although cardiac rehabilitation has been recommended as a nonpharmacologic approach in the management of chronic heart failure, the effect of exercise training on sleep-related breathing abnormalities has not been studied in this patient group. Thus we aimed to evaluate the effects of 6-month, aerobic exercise training on central and obstructive sleep apnea in
Conclusions
Supervised, aerobic exercise training over a period of 6 months was safe, and improved central sleep apnea in association with increased exercise capacity in patients with chronic heart failure from systolic dysfunction. Thus regular physical activities may be an important therapeutic option in the management of this patient population.
Acknowledgment
The authors thank Kiyomi Kanoh, RN, and Yasuhiro Takanaga, BS, for assistance in cardiac rehabilitation.
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This study was supported in part by a grant-in-aid from Kitakyushu Medical Association, Kita-kyushu, Japan.
Conflict of interest: None.