The Prognostic Role of Polysomnography Parameters in Heart Failure Patients with Previous Decompensation

Background: Sleep-disordered breathing (SDB) is a widespread comorbidity in patients with chronic heart failure (HF) and may have a deleterious effect on the pathogenesis of HF. We aimed to evaluate the prognostic role of polysomnography parameters in HF patients with previous decompensation. Methods: 123 patients were included in the prospective cohort study. In addition to the standard examination, all patients underwent polysomnography (PSG). Results: The Kaplan–Meier analysis showed the incidence of the combined endpoint differs between LVEF categories ≤25.5% vs. >25.5% (χ(2) = 9.6, log rank p = 0.002), NTpro-BNP > 680 vs. ≤680 pg/mL (χ(2) = 12.7, log rank p = 0.001), VO(2)peak categories <16 vs. ≥16 mL/min/kg (χ(2) = 14.2, log rank p = 0.001), VE/VCO(2) slope ≥38.5 vs. <38.5 (χ(2) = 14.5, log rank p = 0.001), wake after sleep onset >40 min vs. ≤40 min (χ(2) = 9.7, log rank p = 0.03), and sleep stage 2 (S(2)) <44% vs. ≥44% (χ(2) = 12.4, log rank p = 0.001). Conclusion: Among the PSG parameters, WASO > 40 min and S(2) < 44% were associated with a combined endpoint in patients with previous decompensation of HF. Moreover, higher NT-proBNP and VE/VCO(2) slope, lower LVEF, and VO(2peak) were also independent factors of a poor prognosis.