Breathing Pattern Abnormalities and Arterial Oxygen Desaturation during Sleep in the Congestive Heart Failure Syndrome

Dark, Diana S.; Pingleton, Susan K.; Kerby, Gerald R.; Crabb, J.E.; Gollub, S; Glatter, Thomas R.; Dunn, Marvin

doi:10.1378/chest.91.6.833

Cited by 117 publications

(63 citation statements)

References 14 publications

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“…Optimising medical therapy as first approach remains of utmost importance, as research has shown that often when HF is clinically improved, CSA often improves as well. 65,66 In cases where CSA persists despite aggressive treatment of HF, further therapeutic interventions should be considered. The CANPAP trial did not reveal benefits of treatment with CPAP therapy for CSA.…”

Section: Resultsmentioning

confidence: 99%

Sleep-Disordered Breathing During Congestive Heart Failure: To Intervene or Not to Intervene?

Valika¹,

Costanzo²

2017

Cardiac Failure Review

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Sleep-disordered breathing is common in heart failure patients and is associated with increased morbidity and mortality. Central sleep apnea occurs more commonly in heart failure-reduced ejection fraction, and obstructive sleep apnea occurs more frequently in heart failure with preserved ejection fraction. Although the two types of sleep-disordered breathing have distinct pathophysiologic mechanisms, both contribute to abnormal cardiovascular consequences. Treatment with continuous positive airway pressure for obstructive sleep apnea in heart failure has been well defined, whereas treatment strategies for central sleep apnea in heart failure continue to evolve. Unilateral transvenous neurostimulation has shown promise for the treatment of central sleep apnea. In this paper, we examine the current state of knowledge of treatment options for sleep-disordered breathing in heart failure.

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Section: Resultsmentioning

confidence: 99%

Sleep-Disordered Breathing During Congestive Heart Failure: To Intervene or Not to Intervene?

Valika¹,

Costanzo²

2017

Cardiac Failure Review

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“…Walsh et al 22 demonstrated that patients with stable CHF with the use of furosemide alone, showed increase of slow wave sleep and REM sleep, reduction of HAI and desaturation events, as well as CO 2 increment at the end of the expiration and ventilation reduction a minute after the addition of captopril 75 mg/day for a month. Dark et al 25 studied patients who were admitted due to heart failure decompensation, showing respiratory pattern abnormalities (predominantly central apnea with CSR) in all of them. After CHF compensation during hospital stay with diuretics, vasodilators, antihypertensive drugs, antiarrhythmic drugs and positive inotropics, a new polysomnography was performed with decrease in AHI and a tendency of SatO 2 improvement.…”

Section: Theophyllinementioning

confidence: 99%

Tratamento da respiração de Cheyne-Stokes em pacientes com insuficiência cardíaca congestiva

Freitas¹,

Togeiro²,

Tufik³

2007

Arq. Bras. Cardiol.

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“…Several medical treatments that have been shown to reduce CSR will be reviewed elsewhere in the present article. Current therapeutic options include angiotensin converting enzyme inhibitors [28], b-blockers [51,52], diuretics [53], digoxin, pacemakers [47], valve surgery [54] and heart and lung transplantation [53]. If these interventions fail to control CSR, O 2 treatment may stabilise CSR prior to trials of CPAP, bi-level pressure support ventilation or ASV.…”

Section: Asv In Patients With Csrmentioning

confidence: 99%

Ventilatory support and pharmacological treatment of patients with central apnoea or hypoventilation during sleep

Pevernagie¹,

Janssens²,

Backer³

et al. 2007

European Respiratory Review

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The concept of central sleep apnoea or hypoventilation encompasses hypercapnic central hypoventilation, such as obesity hypoventilation syndrome and eucapnic or hypocapnic central sleep apnoea.Among subjects with eucapnic or hypocapnic central sleep apnoea, several therapeutic options are available for those with Cheyne-Stokes respiration (CSR). CSR is frequent in patients with New York Heart Association stage III and IV chronic heart failure, and in various neurological disorders. In these patients, treatment modalities include optimising cardiac condition and drugs, such as theophylline, acetazolamide and/or oxygen. Ventilatory support, such as nasal continuous positive airway pressure (CPAP), bi-level pressure support, or adaptive servoventilation (ASV), has been shown to improve CSR in patients with cardiac failure; however, convincing evidence that nasal CPAP improves life expectancy in these patients is lacking. Nevertheless, the treatment of associated obstructive sleep-disordered breathing is indicated per se, as it may improve cardiac function.There is currently no proof that bi-level ventilation is superior to nasal CPAP. The few available studies that have focused on ASV have shown satisfactory control of CSR in cardiac failure patients. While ASV is not a first-line treatment choice, it appears to be superior to oxygen, CPAP and bi-level pressure ventilation in controlling the apnoea/hypopnea index and probably sleep fragmentation. As yet there are no data on mortality and, as such, firm conclusions cannot be drawn as to the role of ASV in the management of cardiac failure patients suffering from CSR.Obesity-related hypoventilation has increased dramatically over recent decades due to the epidemic increase in obesity in the developed countries. Obesity hypoventilation syndrome predisposes to the development of pulmonary hypertension and cor pulmonale. Noninvasive home ventilation is increasingly applied in obese patients with hypercapnic respiratory failure, however, initial mechanical ventilatory support can be reduced to nasal continuous positive airway pressure in only a subset of these individuals.

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Breathing Pattern Abnormalities and Arterial Oxygen Desaturation during Sleep in the Congestive Heart Failure Syndrome

Cited by 117 publications

References 14 publications

Sleep-Disordered Breathing During Congestive Heart Failure: To Intervene or Not to Intervene?

Sleep-Disordered Breathing During Congestive Heart Failure: To Intervene or Not to Intervene?

Tratamento da respiração de Cheyne-Stokes em pacientes com insuficiência cardíaca congestiva

Ventilatory support and pharmacological treatment of patients with central apnoea or hypoventilation during sleep

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