RT Journal Article SR Electronic T1 Sleep-disordered breathing, impaired cardiac adrenergic innervation and prognosis in heart failure JF Heart JO Heart FD BMJ Publishing Group Ltd and British Cardiovascular Society SP 1813 OP 1819 DO 10.1136/heartjnl-2015-309215 VO 102 IS 22 A1 Oriana Scala A1 Stefania Paolillo A1 Roberto Formisano A1 Teresa Pellegrino A1 Giuseppe Rengo A1 Paola Gargiulo A1 Fausto De Michele A1 Antonio Starace A1 Antonio Rapacciuolo A1 Valentina Parisi A1 Maria Prastaro A1 Valentina Piscopo A1 Santo Dellegrottaglie A1 Dario Bruzzese A1 Fabiana De Martino A1 Antonio Parente A1 Dario Leosco A1 Bruno Trimarco A1 Alberto Cuocolo A1 Pasquale Perrone-Filardi YR 2016 UL http://heart.bmj.com/content/102/22/1813.abstract AB Objective Unfavourable effects of sleep-disordered breathing (SDB) in heart failure (HF) are mainly mediated by impaired sympathetic activity. Few data are available on SDB and cardiac adrenergic impairment evaluated at myocardial level. The aim of the study was to assess the relationship between SDB, cardiac sympathetic innervation assessed by 123I-metaiodobenzylguanidine (123I-MIBG) imaging and prognosis in HF.Methods Observational, prospective study enrolling patients with HF and reduced systolic function. Patients underwent nocturnal cardiorespiratory monitoring to assess SDB presence by apnoea/hypopnoea index (AHI), and 123I-MIBG imaging to calculate heart-to-mediastinum (H/M) ratios and washout rate. Patients were prospectively followed for 29±18 months for the combined endpoint of cardiovascular death and HF hospitalisation.Results Ninety-four patients (66.1±9.8 years; left ventricular ejection fraction 32±7%) were enrolled; 72 (77%) showed SDB and, compared with non-SDB, significantly reduced early (1.67±0.22 vs 1.77±0.13; p=0.019) and late H/M ratios (1.50±0.22 vs 1.61±0.23; p=0.038). Dividing patients into two groups according to SDB severity, patients with a moderate–severe disturbance (AHI >15; n=43) showed significantly worse survival for the composite study outcome (log-rank test, p=0.001) with respect to patients with mild or no disorder (AHI ≤15; n=51). Adding SDB variables to the already known prognostic role of 123I-MIBG imaging, we observed a worse survival in patients with both SDB and H/M impairment.Conclusions Patients with systolic HF and SDB show more impaired cardiac adrenergic innervation assessed by 123I-MIBG imaging, and more adverse prognosis compared with HF patients without SDB.