Cheyne-Stokes Respiration in Patients with Heart Failure: Prevalence, Causes, Consequences and Treatments

Brack, Thomas; Randerath, Winfried; Bloch, Konrad E.

doi:10.1159/000331457

Cited by 60 publications

(28 citation statements)

References 209 publications

(157 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Alternatively, the Cheyne-Stokes respiration may be a consequence of heart failure in the context of FD as this was shown in non-Fabry patients [48] …”

Section: Sleep-related Breathing Disorder and Muscular Involvementmentioning

confidence: 93%

Pulmonary involvement in Fabry disease: Overview and perspectives

Franzen

Krayenbuehl

Lidove

et al. 2013

European Journal of Internal Medicine

View full text Add to dashboard Cite

Fabry disease (FD) is an X-linked lysosomal storage disorder caused by deficiency of alphagalactosidase A, which leads to storage of sphingolipids in virtually all human cells and consequently to organ dysfunction. Pulmonary involvement is still debated. But, obstructive lung disease is up to ten times more prevalent in patients with FD compared to general public. Also, an accelerated decline in forced expiratory volume in one second (FEV1) over time was observed in these patients. Lysosomal storage of glycosphingolipids is considered leading to small airway disease via hyperplasia of the bronchiolar smooth muscle cells. Larger airways may become involved with ongoing disease process. There is no evidence for involvement of the lung interstitium in FD. The effect of enzyme replacement therapy on respiratory involvement remains to be determined in large, prospective controlled trials. AbstractFabry disease (FD) is an X-linked lysosomal storage disorder caused by deficiency of alpha-

show abstract

“…Alternatively, the Cheyne-Stokes respiration may be a consequence of heart failure in the context of FD as this was shown in non-Fabry patients [48] …”

Section: Sleep-related Breathing Disorder and Muscular Involvementmentioning

confidence: 93%

Pulmonary involvement in Fabry disease: Overview and perspectives

Franzen

Krayenbuehl

Lidove

et al. 2013

European Journal of Internal Medicine

View full text Add to dashboard Cite

show abstract

“…Previous studies have shown that over a third of patients with right heart failure due to pPH suffer from Cheyne-Stokes respiration/central sleep apnea [15,16], similar to patients with left ventricular heart failure. In left heart failure, noninvasive positive pressure ventilation or oxygen might be effective therapies as adjuncts to drug treatment [17]; however, studies in pPH are lacking. Other reasons for reduced nocturnal oxygen saturation (Sp o 2 ) might be an increased ventilation perfusion mismatch and impairment of respiratory muscle efficiency due to the recumbent position.…”

Section: Introductionmentioning

confidence: 99%

Daytime Measurements Underestimate Nocturnal Oxygen Desaturations in Pulmonary Arterial and Chronic Thromboembolic Pulmonary Hypertension

et al. 2012

Self Cite

View full text Add to dashboard Cite

Background: Nocturnal hypoxemia is important in precapillary pulmonary hypertension (pPH) as it worsens pulmonary hemodynamics. Whether daytime oxygen saturation (Spo₂) predicts nocturnal hypoxemia in pPH patients has not been conclusively studied. Objectives: To investigate the prevalence of nocturnal hypoxemia in comparison to daytime Spo₂ and disease severity in ambulatory patients with pulmonary hypertension. Methods: Consecutive patients diagnosed with pPH classified as either pulmonary arterial (PAH) or chronic thromboembolic pPH (CTEPH) had daytime resting and exercise Spo₂ (at the end of a 6-min walk test); thereafter, they underwent overnight pulse oximetry at home. Functional class, pro-brain natriuretic peptide (pro-BNP) and the tricuspid pressure gradient were assessed. Results: Sixty-three patients [median (quartiles) age 62 (53; 71), 43 females] with PAH (n = 44) and CTEPH (n = 19) were included. The resting Spo₂, exercise Spo₂, and mean nocturnal Spo₂ were 95% (92; 96), 88% (81; 95), and 89% (85; 92), respectively. Forty-nine patients (77%) spent >10% of the night with Spo₂ <90% (desaturators), and 33 (52%) spent >50% of the night with Spo₂ <90% (sustained desaturators). The positive predictive values of daytime Spo₂ >90% for being a nocturnal nondesaturator or sustained nondesaturator were 25 and 53%, respectively. Nocturnal Spo₂ was negatively correlated with the tricuspid pressure gradient, but not with functional class, 6-min walk test, or pro-BNP. Conclusions: Nocturnal hypoxemia is very common in PAH and CTEPH despite often normal daytime Spo₂ and reflects disease severity. Nocturnal pulse oximetry should be considered in the routine evaluation of pPH patients and research should be directed toward the treatment of nocturnal desaturation in pPH.

show abstract

“…Even though this link between SDB and diastolic dysfunction is evident, the underlying pathophysiological mechanisms are still not well characterized. It has been hypothesized that both elevations in nocturnal BP and activation of the sympathetic nervous system might contribute to this effect [29,30,31] by increasing LV afterload [32]. Furthermore, futile inspiratory efforts hallmarking obstructive sleep apnea might increase LV transmural pressure and hence afterload by inducing negative intrathoracic pressures [32], ultimately provoking diastolic dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Effects of Auto-Servo Ventilation on Patients with Sleep-Disordered Breathing, Stable Systolic Heart Failure and Concomitant Diastolic Dysfunction: Subanalysis of a Randomized Controlled Trial

Birner¹,

Sériès

Benjamin

et al. 2013

Respiration

View full text Add to dashboard Cite

Background: Systolic heart failure (HF) is frequently accompanied by diastolic dysfunction and sleep-disordered breathing (SDB). Objectives: The objective of this subset analysis was to determine effect sizes of auto-servo ventilation (ASV and biphasic positive airway pressure ASV) on echocardiographic measures of diastolic function in patients with systolic HF and SDB. Methods: Thirty-two patients with stable systolic HF, concomitant diastolic dysfunction [age 66 ± 9 years old, left ventricular (LV) ejection fraction: 30 ± 7% and New York Heart Association class II: 72%] and SDB (apnea-hypopnea index, AHI: 48 ± 19/h; 53% had predominantly obstructive sleep apnea) receiving either ASV (n = 19) or optimal medical treatment (control, n = 13) were analyzed in a randomized controlled clinical trial. Polysomnographic and echocardiographic measurements were obtained at baseline and after 12 weeks. Results: AHI significantly improved in the ASV group compared to the control group (-39 ± 18 vs. -0.2 ± 13.2/h, p < 0.001). At baseline, 24 (75%) patients had impaired LV relaxation, and 8 (25%) had a pseudo-normalized filling pattern. At the 12-week control visit, diastolic function assessed by the isovolumetric relaxation time (-10.3 ± 26.1 vs. 9.3 ± 49.1, p = 0.48) and deceleration time (-43.9 ± 88.8 vs. 12.4 ± 68.8, p = 0.40) tended to improve after ASV treatment, but did not reach statistical significance. Likewise, the proportion of patients whose diastolic dysfunction improved was nonsignificantly higher in the ASV than in the control group, respectively (37 vs. 15%, p = 0.25). Conclusions: ASV treatment efficiently abolishes SDB in patients with stable systolic HF and concomitant diastolic dysfunction, and was associated with a statistically nonsignificant improvement in measures of diastolic dysfunction. Thus, these data provide estimates of effect size and justify the evaluation of the effects of ASV on diastolic function in larger randomized controlled trials.

show abstract

Cheyne-Stokes Respiration in Patients with Heart Failure: Prevalence, Causes, Consequences and Treatments

Cited by 60 publications

References 209 publications

Pulmonary involvement in Fabry disease: Overview and perspectives

Pulmonary involvement in Fabry disease: Overview and perspectives

Daytime Measurements Underestimate Nocturnal Oxygen Desaturations in Pulmonary Arterial and Chronic Thromboembolic Pulmonary Hypertension

Effects of Auto-Servo Ventilation on Patients with Sleep-Disordered Breathing, Stable Systolic Heart Failure and Concomitant Diastolic Dysfunction: Subanalysis of a Randomized Controlled Trial

Contact Info

Product

Resources

About