TY - JOUR T1 - Sleep-disordered breathing, impaired cardiac adrenergic innervation and prognosis in heart failure JF - Heart JO - Heart SP - 1813 LP - 1819 DO - 10.1136/heartjnl-2015-309215 VL - 102 IS - 22 AU - Oriana Scala AU - Stefania Paolillo AU - Roberto Formisano AU - Teresa Pellegrino AU - Giuseppe Rengo AU - Paola Gargiulo AU - Fausto De Michele AU - Antonio Starace AU - Antonio Rapacciuolo AU - Valentina Parisi AU - Maria Prastaro AU - Valentina Piscopo AU - Santo Dellegrottaglie AU - Dario Bruzzese AU - Fabiana De Martino AU - Antonio Parente AU - Dario Leosco AU - Bruno Trimarco AU - Alberto Cuocolo AU - Pasquale Perrone-Filardi Y1 - 2016/11/15 UR - http://heart.bmj.com/content/102/22/1813.abstract N2 - 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. ER -