The prevalence of sleep-disordered breathing and associated risk factors in patients with decompensated congestive heart failure in Mozambique.

STUDY OBJECTIVES: Sleep-disordered breathing (SDB) is common in patients with congestive heart failure (CHF) and has important implications regarding symptoms and prognosis. However, the burden of SDB on those with heart failure has not been well characterized in developing countries; this includes Mozambique in sub-Saharan Africa. Diagnosing SDB in individuals with CHF is important because treatment of SDB may improve outcomes.

METHODS: Between September of 2014 and April of 2017, patients hospitalized in a specialized cardiology unit in Maputo, Mozambique with decompensated congestive heart failure were recruited, utilizing convenience sampling. We determined the prevalence of SDB and associated risk factors.

RESULTS: 165 patients were recruited, of which 145 had evaluable sleep study data. The overall prevalence of SDB in patients with decompensated CHF was 72%, and of these 46% had Cheyne-Stokes respirations (CSR). Male sex, higher BMI, and lower left ventricular ejection fraction (LVEF) were all associated with a higher likelihood of SDB and more severe SDB. Cheyne-Stokes respirations was associated with male sex, lower ejection fraction, and larger left atrial size.

CONCLUSIONS: We conclude that, in sub-Saharan Africa, SDB is common in decompensated CHF and strongly predicted by demographic and echocardiographic parameters. This study highlights the need for the development of diagnostic tools and management strategies for patients with severe heart failure in resource-limited settings.