Severe aortic valve stenosis in the elderly: high prevalence of sleep-related breathing disorders

Stefanie Keymel,1 Katharina Hellhammer,1 Tobias Zeus,1 Marc Merx,2 Malte Kelm,1 Stephan Steiner3 1Department of Cardiology, Pneumology, and Vascular Diseases, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, 2Department of Cardiology, Vascular Diseases and Intens...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Keymel S, Hellhammer K, Zeus T, Merx M, Kelm M, Steiner S
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Aortic valve stenosis sleep related breathing disorders transcutan aortic valve implantation Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/950ffdbad7be4003b9e506a5d9496cd2
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:950ffdbad7be4003b9e506a5d9496cd2
record_format	dspace
spelling	oai:doaj.org-article:950ffdbad7be4003b9e506a5d9496cd22021-12-02T06:09:56ZSevere aortic valve stenosis in the elderly: high prevalence of sleep-related breathing disorders1178-1998https://doaj.org/article/950ffdbad7be4003b9e506a5d9496cd22015-09-01T00:00:00Zhttps://www.dovepress.com/severe-aortic-valve-stenosis-in-the-elderly-high-prevalence-of-sleep-r-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Stefanie Keymel,1 Katharina Hellhammer,1 Tobias Zeus,1 Marc Merx,2 Malte Kelm,1 Stephan Steiner3 1Department of Cardiology, Pneumology, and Vascular Diseases, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, 2Department of Cardiology, Vascular Diseases and Intensive Care Medicine, KRHKlinikum Robert Koch Gehrden, Gehrden, 3Department of Cardiology, Pneumology and Intensive Care Medicine, St Vincenz Hospital, Limburg, Germany Background: Aortic valve stenosis is common in the elderly, with a prevalence of nearly 3% in patients aged 75 years or older. Despite the fact that sleep-related breathing disorders (SRBD) are thought to be associated with cardiac disease, little is known about their prevalence in this patient cohort. The purpose of this study was to evaluate the prevalence of SRBD in older patients with aortic valve stenosis admitted for transcatheter aortic valve implantation.Methods: Forty-eight consecutive patients (mean age 81±6 years; 37.5% male) with symptomatic aortic valve stenosis and considered for transcatheter aortic valve replacement were screened for SRBD. Sleep studies were performed by in-hospital unattended cardiorespiratory polygraphy measuring nasal air flow, chest and abdominal efforts, as well as oxygen saturation and body position. The patients were divided in subgroups dependent on the documented apnea–hypopnea index (AHI; no SRBD was defined as an AHI of <5 events/hour; mild SRBD as AHI 5–15 events/hour, and moderate to severe SRBD as AHI ≥15 events/hour).Results: Thirty-seven patients (77%) had SRBD defined as an AHI of ≥5 events/hour. Eleven patients had an unremarkable investigation, with AHI <5 events/hour (mean 3.0±1.3 events/hour). Among patients with sleep apnea, 19 patients had mild SRBD, with an AHI of 5–15 events/hour (mean 9.9±3.4 events/hour) and 18 patients had moderate to severe SRBD (mean 26.6±11.3 events/hour). Mainly, obstructive apneas were found. Subgroups were not different regarding EuroSCORE (European System for Cardiac Operative Risk Evaluation) or aortic valve area. Also, no correlations were found between AHI and the additive or logistic EuroSCORE or aortic valve area. Significant correlations were found for AHI and N-terminal of the prohormone brain natriuretic peptide (r=0.53; P=0.003) and for AHI and glomerular filtration rate (r=-0.39; P=0.007). Conclusion: SRBD is common in elderly patients with symptomatic aortic valve stenosis admitted for transcatheter aortic valve replacement. Interestingly, this finding is not reflected by the currently used risk scores. Further randomized studies are needed to evaluate the clinical significance of concomitant SRBD in the management of severe aortic stenosis. Keywords: aortic valve stenosis, sleep-related breathing disorders, transcatheter aortic valve replacementKeymel SHellhammer KZeus TMerx MKelm MSteiner SDove Medical PressarticleAortic valve stenosissleep related breathing disorderstranscutan aortic valve implantationGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 10, Pp 1451-1456 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Aortic valve stenosis sleep related breathing disorders transcutan aortic valve implantation Geriatrics RC952-954.6
spellingShingle	Aortic valve stenosis sleep related breathing disorders transcutan aortic valve implantation Geriatrics RC952-954.6 Keymel S Hellhammer K Zeus T Merx M Kelm M Steiner S Severe aortic valve stenosis in the elderly: high prevalence of sleep-related breathing disorders
description	Stefanie Keymel,1 Katharina Hellhammer,1 Tobias Zeus,1 Marc Merx,2 Malte Kelm,1 Stephan Steiner3 1Department of Cardiology, Pneumology, and Vascular Diseases, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, 2Department of Cardiology, Vascular Diseases and Intensive Care Medicine, KRHKlinikum Robert Koch Gehrden, Gehrden, 3Department of Cardiology, Pneumology and Intensive Care Medicine, St Vincenz Hospital, Limburg, Germany Background: Aortic valve stenosis is common in the elderly, with a prevalence of nearly 3% in patients aged 75 years or older. Despite the fact that sleep-related breathing disorders (SRBD) are thought to be associated with cardiac disease, little is known about their prevalence in this patient cohort. The purpose of this study was to evaluate the prevalence of SRBD in older patients with aortic valve stenosis admitted for transcatheter aortic valve implantation.Methods: Forty-eight consecutive patients (mean age 81±6 years; 37.5% male) with symptomatic aortic valve stenosis and considered for transcatheter aortic valve replacement were screened for SRBD. Sleep studies were performed by in-hospital unattended cardiorespiratory polygraphy measuring nasal air flow, chest and abdominal efforts, as well as oxygen saturation and body position. The patients were divided in subgroups dependent on the documented apnea–hypopnea index (AHI; no SRBD was defined as an AHI of <5 events/hour; mild SRBD as AHI 5–15 events/hour, and moderate to severe SRBD as AHI ≥15 events/hour).Results: Thirty-seven patients (77%) had SRBD defined as an AHI of ≥5 events/hour. Eleven patients had an unremarkable investigation, with AHI <5 events/hour (mean 3.0±1.3 events/hour). Among patients with sleep apnea, 19 patients had mild SRBD, with an AHI of 5–15 events/hour (mean 9.9±3.4 events/hour) and 18 patients had moderate to severe SRBD (mean 26.6±11.3 events/hour). Mainly, obstructive apneas were found. Subgroups were not different regarding EuroSCORE (European System for Cardiac Operative Risk Evaluation) or aortic valve area. Also, no correlations were found between AHI and the additive or logistic EuroSCORE or aortic valve area. Significant correlations were found for AHI and N-terminal of the prohormone brain natriuretic peptide (r=0.53; P=0.003) and for AHI and glomerular filtration rate (r=-0.39; P=0.007). Conclusion: SRBD is common in elderly patients with symptomatic aortic valve stenosis admitted for transcatheter aortic valve replacement. Interestingly, this finding is not reflected by the currently used risk scores. Further randomized studies are needed to evaluate the clinical significance of concomitant SRBD in the management of severe aortic stenosis. Keywords: aortic valve stenosis, sleep-related breathing disorders, transcatheter aortic valve replacement
format	article
author	Keymel S Hellhammer K Zeus T Merx M Kelm M Steiner S
author_facet	Keymel S Hellhammer K Zeus T Merx M Kelm M Steiner S
author_sort	Keymel S
title	Severe aortic valve stenosis in the elderly: high prevalence of sleep-related breathing disorders
title_short	Severe aortic valve stenosis in the elderly: high prevalence of sleep-related breathing disorders
title_full	Severe aortic valve stenosis in the elderly: high prevalence of sleep-related breathing disorders
title_fullStr	Severe aortic valve stenosis in the elderly: high prevalence of sleep-related breathing disorders
title_full_unstemmed	Severe aortic valve stenosis in the elderly: high prevalence of sleep-related breathing disorders
title_sort	severe aortic valve stenosis in the elderly: high prevalence of sleep-related breathing disorders
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/950ffdbad7be4003b9e506a5d9496cd2
work_keys_str_mv	AT keymels severeaorticvalvestenosisintheelderlyhighprevalenceofsleeprelatedbreathingdisorders AT hellhammerk severeaorticvalvestenosisintheelderlyhighprevalenceofsleeprelatedbreathingdisorders AT zeust severeaorticvalvestenosisintheelderlyhighprevalenceofsleeprelatedbreathingdisorders AT merxm severeaorticvalvestenosisintheelderlyhighprevalenceofsleeprelatedbreathingdisorders AT kelmm severeaorticvalvestenosisintheelderlyhighprevalenceofsleeprelatedbreathingdisorders AT steiners severeaorticvalvestenosisintheelderlyhighprevalenceofsleeprelatedbreathingdisorders
_version_	1718400065138065408

Severe aortic valve stenosis in the elderly: high prevalence of sleep-related breathing disorders

Ejemplares similares