Cheyne-Stokes Respiration During Sleep in Congestive Heart Failure

Quaranta, A. J.; D’Alonzo, Gilbert E.; Krachman, Samuel L.

doi:10.1378/chest.111.2.467

Cited by 51 publications

(40 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Minute ventilation plays a significant role in neonatal intensive care units for ventilatory management of neonates (7,8). In ambulatory patients, it holds significant promise for improving the management of a number of different diseases, such as restrictive lung disease (5), chronic obstructive pulmonary disease (10,20), and CSR in heart failure (24). Abnormal respiratory patterns are prevalent in patients with heart failure and LV function may improve by the treatment of sleep-disordered breathing (16).…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, measurement of TV in ambulatory settings (2,17,34) and in long-term monitoring outside the hospital would be desirable for a variety of disorders that are known to be associated with respiratory abnormalities, such as chronic obstructive pulmonary disease (10,20), restrictive lung disease (5), and Cheyne-Stokes respiration (CSR) in heart failure (24). In particular, CSR is a form of sleep-disordered breathing characterized by oscillations of ventilation between apnea and hyperapnea with a crescendo-diminuendo alteration in TV (24), which has been associated with cardiac dysrhythmias including atrioventricular block (15) and ventricular ectopy (18), and is shown to be a marker of worse prognosis and increased mortality in patients with heart failure (24). These clinical observations exemplify the complex interplay among the respiratory, cardiovascular, and autonomic systems and highlight the need for tools to monitor respiratory and cardiovascular parameters in ambulatory patients with heart failure.…”

mentioning

confidence: 99%

See 1 more Smart Citation

An optimized method for estimating the tidal volume from intracardiac or body surface electrocardiographic signals: implications for estimating minute ventilation

Sayadi

Weiss

Merchant

et al. 2014

American Journal of Physiology-Heart and Circulatory Physiology

View full text Add to dashboard Cite

The ability to accurately monitor tidal volume (TV) from electrocardiographic (ECG) signals holds significant promise for improving diagnosis treatment across a variety of clinical settings. The objective of this study was to develop a novel method for estimating the TV from ECG signals. In 10 mechanically ventilated swine, we collected intracardiac electrograms from catheters in the coronary sinus (CS), left ventricle (LV), and right ventricle (RV), as well as body surface electrograms, while TV was varied between 0 and 750 ml at respiratory rates of 7–14 breaths/min. We devised an algorithm to determine the optimized respirophasic modulation of the amplitude of the ECG-derived respiratory signal. Instantaneous measurement of respiratory modulation showed an absolute error of 72.55, 147.46, 85.68, 116.62, and 50.89 ml for body surface, CS, LV, RV, and RV-CS leads, respectively. Minute TV estimation demonstrated a more accurate estimation with an absolute error of 69.56, 153.39, 79.33, 122.16, and 48.41 ml for body surface, CS, LV, RV, and RV-CS leads, respectively. The RV-CS and body surface leads provided the most accurate estimations that were within 7 and 10% of the true TV, respectively. Finally, the absolute error of the bipolar RV-CS lead was significantly lower than any other lead configuration ( P < 0.0001). In conclusion, we have demonstrated that ECG-derived respiratory modulation provides an accurate estimation of the TV using intracardiac or body surface signals, without the need for additional hardware.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

An optimized method for estimating the tidal volume from intracardiac or body surface electrocardiographic signals: implications for estimating minute ventilation

Sayadi

Weiss

Merchant

et al. 2014

American Journal of Physiology-Heart and Circulatory Physiology

View full text Add to dashboard Cite

show abstract

“…[7][8][9][10] Clinical studies have identified several possibilities in patients with PB, 11,12 particularly hyperventilation or hypocapnia. 6,[13][14][15][16] Prolonged circulation delay 8,17 and increased chemoreceptor sensitivity 18 have also been implicated. The role of circulation delay is controversial, partly because of animal work 19 that had to prolong it to a biologically implausible 2 to 5 minutes to engender PB.…”

mentioning

confidence: 99%

Quantitative General Theory for Periodic Breathing in Chronic Heart Failure and its Clinical Implications

et al. 2000

View full text Add to dashboard Cite

Background-In patients with chronic heart failure (CHF), periodic breathing (PB) predicts poor prognosis. Clinical studies have identified numerous risk factors for PB (which also includes Cheyne-Stokes respiration). Computer simulations have shown that oscillations can arise from delayed negative feedback. However, no simple general theory quantitatively explains PB and its mechanisms of treatment using widely-understood clinical concepts. Therefore, we introduce a new approach to the quantitative analysis of the dynamic physiology governing cardiorespiratory stability in CHF. Methods and Results-An algebraic formula was derived (presented as a simple 2D plot), enabling prediction from easily acquired clinical data to determine whether respiration will be unstable. Clinical validation was performed in 20 patients with CHF (10 with PB and 10 without) and 10 healthy normal subjects. Measurements, including chemoreflex sensitivity (S) and delay (␦), alveolar volume (V L ), and end-tidal CO 2 fraction (C ), were applied to the stability formula. The breathing pattern was correctly predicted in 28 of the 30 subjects. The principal combined parameter (C S)ϫ(␦/V L ) was higher in patients with PB (14.2Ϯ3.0) than in those without PB (3.1Ϯ0.5; Pϭ0.0005) or in normal controls (2.4Ϯ0.5; Pϭ0.0003). This was because of differences in both chemoreflex sensitivity (1749Ϯ235 versus 620Ϯ103 and 526Ϯ104 L/min per atm CO 2 ; Pϭ0.0001 and PϽ0.0001, respectively) and chemoreflex delay (0.53Ϯ0.06 vs 0.40Ϯ0.06 and 0.30Ϯ0.04 min; PϭNS and Pϭ0.02). Conclusion-This analytical approach identifies the physiological abnormalities that are important in the genesis of PB and explicitly defines the region of predicted instability. The clinical data identify chemoreflex gain and delay time (rather than hyperventilation or hypocapnia) as causes of PB.

show abstract

“…La respiración de Cheyene Stokes está presente en el 40% de los pacientes con ICFE-r, se caracteriza por periodos de hipernea-apnea y es un factor de mal pronóstico, especialmente si se presenta durante el día [20,88]. Trastornos del sueño, confusión y desorientación, están relacionados con baja perfusión cerebral [89].…”

Section: ¿Se Despierta Ahogado En La Noche?unclassified

Semiología y diagnóstico diferencial de la insuficiencia cardíaca crónica

Giraldo

Salazar

Buitrago-Toro

et al. 2018

Rev. Médica Risaralda

View full text Add to dashboard Cite

Resumen: la insuficiencia cardiaca es un síndrome clínico de etiología multifactorial de alta prevalencia en la población mundial y latinoamericana debido al aumento en la expectativa de vida. Actualmente el diagnóstico de este se basa en los hallazgos de pruebas diagnósticas como el ecocardiograma o pépticos natriuréticos, pero es importante para el personal médico conocer e identificar de manera clara los signos y síntomas que presentan los pacientes con insuficiencia cardiaca, pues es una tendencia actual el desconocer datos semiológicos importantes que fueron descritos y refinados durante los siglos XIX y XX, y que ahora son validados por la medicina basada en la evidencia. Lo anterior cobra importancia pues el papel que debe tener la creciente tecnología no es acabar o desplazar el conocimiento clínico, si no ser una herramienta complementaria para el buen cuidado del paciente y así llegar al mejor desenlace posible.Este artículo pretende brindar datos basados en la evidencia para hacer de la clínica la parte fundamental del proceso diagnóstico y de la relación médico paciente. También intenta ser una guía útil para estudiantes de medicina o médicos que se desenvuelven en sitios con pocos recursos económicos, ya que la elección adecuada de un examen diagnóstico solo puede ser llevada a cabo mediante un buen interrogatorio y examen físico.Palabras clave: insuficiencia cardiaca; Diagnóstico; Signos y Síntomas; Colombia Copyright © Facultad de Ciencias de la Salud de la Universidad Tecnológica de Pereira. 1995-2017. Todos los derechos reservados ® Semiology and differential diagnosis of chronic heart failure Abstract: heart failure is a clinical syndrome with multifactorial etiology of high prevalence in the world and Latin American population due to the increase in life expectancy. Currently the diagnosis of this is based on the findings of diagnostic tests such as echocardiogram or natriuretic peptic, but it is important for the medical staff to know and clearly identify the signs and symptoms that patients with heart failure present, as it is a current trend To ignore important semiological data that were described and refined during the nineteenth and twentieth centuries, and which are now validated by evidencebased medicine. This is important because the role of growing technology is not to end or displace clinical knowledge, if not to be a complementary tool for good patient care and thus reach the best possible outcome.This article aims to provide data based on the evidence to make the clinic the fundamental part of the diagnostic process and the patient medical relationship. It is also intended to be a useful guide for medical students or physicians operating in poorly funded areas, as the proper choice of a diagnostic examination can only be carried out through a thorough examination and physical examination.Key words: heart failure; Diagnosis; Signs and Symptoms; Colombia Copyright © Facultad de Ciencias de la Salud de la Universidad Tecnológica de Pereira. 1995-2017. All rights reserved ®. Introducc...

show abstract

Cheyne-Stokes Respiration During Sleep in Congestive Heart Failure

Cited by 51 publications

References 41 publications

An optimized method for estimating the tidal volume from intracardiac or body surface electrocardiographic signals: implications for estimating minute ventilation

An optimized method for estimating the tidal volume from intracardiac or body surface electrocardiographic signals: implications for estimating minute ventilation

Quantitative General Theory for Periodic Breathing in Chronic Heart Failure and its Clinical Implications

Semiología y diagnóstico diferencial de la insuficiencia cardíaca crónica

Contact Info

Product

Resources

About