Cheyne–Stokes respiration: friend or foe?: Figure 1

Naughton, Matthew T.

doi:10.1136/thoraxjnl-2011-200927

Cited by 174 publications

(85 citation statements)

References 46 publications

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“…It is not yet known whether CSR is an epiphenomenon in the setting of heart failure or whether it may itself lead to increased risk or progression of heart failure (40). CSR is associated with heart rate and blood pressure oscillations, in phase with respiration (40). However the precise mechanism linking CSR-CSA with BP and HR oscillations remains to be determined.…”

Section: Sleep Breathing Disorders and Ansmentioning

confidence: 99%

“…Although less common than OSA overall, CSR is very common in © C I C E d i z i o n i I n t e r n a z i o n a l i subjects exposed to high altitude (39) and among patients with CHF (24). It is not yet known whether CSR is an epiphenomenon in the setting of heart failure or whether it may itself lead to increased risk or progression of heart failure (40). CSR is associated with heart rate and blood pressure oscillations, in phase with respiration (40).…”

Section: Sleep Breathing Disorders and Ansmentioning

confidence: 99%

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Sympathovagal balance changes in sleep breathing disorders

Patruno¹

2014

sob

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SummaryThe autonomic nervous system (ANS) plays a leading role in controlling visceral functions and it is well known that the increase of sympathetic activity underlies most of cardiovascular diseases such as hypertension, heart failure, myocardial infarction and arrhythmias. On the other hand parasympathetic activity acts as protective factor against the above mentioned conditions. Sleep breathing disorders (SBD) are commonly divided in three syndromes: obstructive sleep apnoea syndrome, central sleep apnoea syndrome and Cheyne-Stokes breathing syndrome, the latter two both characterized by cyclic non-obstructive breathing patterns. Cheyne-Stokes Respiration is a form of periodic breathing characterized by a crescendo-decrescendo pattern of ventilation with (CSR-CSA) or without (CSR) central apnoea. Obstructive sleep apnea (OSA) is significantly associated with increased cardiovascular morbidity and mortality. OSA exerts strong modulatory effects on the autonomic nervous system through a number of mechanisms including central respiratory-cardiac coupling in the brain stem, chemo-reflex stimulation, baro-reflexes, and reflexes relating to lung inflation. EEG arousals, often related to apnea termination, also represent the final way of autonomic activation. CSR is common among patients with congestive heart failure, being present in 30-40% of the two largest reported. If CSR "per se" promotes an increase of sympathetic outflow during sleep is not really known.Several lines of argument would support the hypothesis that CSR may be a compensatory mechanism for severe HF.

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Section: Sleep Breathing Disorders and Ansmentioning

confidence: 99%

Section: Sleep Breathing Disorders and Ansmentioning

confidence: 99%

Sympathovagal balance changes in sleep breathing disorders

Patruno¹

2014

sob

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“…4 The other intriguing possibility is that Cheyne-Stokes respiration may be an adaptive not a pathologic mechanism that should be ameliorated. 5 It is also possible that participants who were randomized to ASV were overall sicker than the control group. The difference in the arrhythmic drug use between the two groups suggests that some baseline differences may have been present.…”

Section: Co M M Entarymentioning

confidence: 99%

Adaptive Servo-Ventilation and Central Apnea Associated with Systolic Heart Failure

Shafazand

Badr

2016

Journal of Clinical Sleep Medicine

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In individuals with symptomatic congestive heart failure (left ventricular ejection fraction ≤ 45%) and predominately central sleep apnea, does treatment of the sleep apnea with adaptive servo-ventilation (ASV), in addition to guideline based medical treatment change time to first event (composite of first event of death from any cause, lifesaving cardiovascular intervention [cardiac transplantation, implantation of a ventricular assist device, resuscitation after sudden cardiac arrest, or appropriate lifesaving shock], or unplanned hospitalization for worsening heart failure)? Methods DesignMulti-center, randomized, controlled trial; clinicaltrials.gov identifier: NCT00733343. AllocationRandomization was conducted by a centralized computer system. Allocation was stratified by country. The randomization sequence was concealed. BlindingThe investigators and participants were not blinded to study arm assignment. The primary outcome measurements were blinded. Follow-up periodThis was an event driven analysis. Participants were recruited over a period of 60 months with a total of 2-year follow-up until the target 651 observed events was reached. SettingPatients were recruited from each investigator's network of sleep and cardiology practices.

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“…Naughton some years ago in which he said CSA was a good thing and should not be treated 6 . He quoted several potential mechanisms for this that I will not go into detail here.…”

Section: Monash University Australia 2 University Of Warwick Covenmentioning

confidence: 99%