{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T01:50:57Z","timestamp":1784598657284,"version":"3.55.0"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Central apneas (CA) are a frequent comorbidity in patients with heart failure (HF) and are associated with worse prognosis. The clinical and prognostic relevance of CA in each sex is unknown.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Consecutive outpatients with HF with either reduced or mildly reduced left ventricular ejection fraction (n=550, age 65\u00b112\u00a0years, left ventricular ejection fraction 32%\u00b19%, 21% women) underwent a 24\u2010hour ambulatory polygraphy to evaluate CA burden and were followed up for the composite end point of cardiac death, appropriate implantable cardioverter\u2010defibrillator shock, or first HF hospitalization. Compared with men, women were younger, had higher left ventricular ejection fraction, had lower prevalence of ischemic etiology and of atrial fibrillation, and showed lower apnea\u2010hypopnea index (expressed as median [interquartile range]) at daytime (3 [0\u20139] versus 10 [3\u201320] events\/hour) and nighttime (10 [3\u201321] versus 23 [11\u201336] events\/hour) (all\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), despite similar neurohormonal activation and HF therapy. Increased chemoreflex sensitivity to either hypoxia or hypercapnia (evaluated in 356 patients, 65%, by a rebreathing test) was less frequent in women (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), but chemoreflex sensitivity to hypercapnia was a predictor of apnea\u2010hypopnea index in both sexes. At adjusted survival analysis, daytime apnea\u2010hypopnea index \u226515 events\/hour (hazard ratio [HR], 2.70; 95% CI, 1.06\u20137.34;\n              <jats:italic>P<\/jats:italic>\n              =0.037), nighttime apnea\u2010hypopnea index \u226515 events\/hour (HR, 2.84; 95% CI, 1.28\u20136.32;\n              <jats:italic>P<\/jats:italic>\n              =0.010), and nighttime CA index \u226510 events\/hour (HR, 5.01; 95% CI, 1.88\u201313.4;\n              <jats:italic>P<\/jats:italic>\n              =0.001) were independent predictors of the primary end point in women but not in men (all\n              <jats:italic>P<\/jats:italic>\n              &gt;0.05), also after matching women and men for possible confounders.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">In chronic HF, CA are associated with a greater risk of adverse events in women than in men.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.024103","type":"journal-article","created":{"date-parts":[[2022,2,22]],"date-time":"2022-02-22T10:03:19Z","timestamp":1645524199000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Central Apneas Are More Detrimental in Female Than in Male Patients With Heart Failure"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7453-3748","authenticated-orcid":false,"given":"Francesco","family":"Gentile","sequence":"first","affiliation":[{"name":"Fondazione Toscana G. 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