A worse cardiac function revealed by TDI in patients with congestive heart failure and Cheyne-Stokes breathing

Background Tissue Doppler Imaging (TDI) is used to better stratify dead risk in patients with congestive heart failure. Up today few studies have used this method to investigate the differences between patients with HF and Cheyne-Stokes breathing (CSB) with ones who haven’t it. The aim of this study was to evaluate the impact of CSB on myocardic function by TDI. Materials and Methods 50 consecutive patients who afferent to Heart Failure Unit of University of Foggia were studied by conventional and Tissue Doppler echocardiography, and underwent to nocturnal poligraphy to evaluate the presence of sleep apnea and CSB Results Mean age was 61,9±11,3 years, LVEF 38,41±11,5% and BMI was 31,6±3,9. 10 patients (20%) had high prevalence of CSB during the night. There wasn’t any differences between this group and others ones about age, BMI, LVEF but there were many differences at TDI. Respect to patients without CSB, in ones who had it, late (A’) diastolic peak velocity was lower (5,47±2,3 vs 7,9±2,6, p=0.04); the ratio of early to late diastolic velocity (E’/A’) was higher (1,70±1,48 vs 0,76±0,31, p<0.01); EAS index [E’/(A’ x S’)] was higher (0,36±0,29 vs 0,16±0,11, p<0.01) and Isovolumic Relaxation Time (IRT) was lower (60,35±36,6 vs 113,5±48,3, p=0,04). There was also a positive correlation between percentage of CSB during the night and EAS index (0,76, p<0.01) and E’/A’ (0,88, p<0.001). The presence of obstructive sleep apnea did not infl uenced this results. Conclusions Patients with HF and CSB have a worse cardiac function in compare with ones who haven’t it. This condition is better evaluate by TDI that conventional echocardiography.