Perger, Elisa and Inami, Toru and Lyons, Owen D. and Alshaer, Hisham and Smith, Stephanie and Floras, John S. and Logan, Alexander G. and Arzt, Michael and Duran Cantolla, Joaquin and Delgado, Diego and Fitzpatrick, Michael and Fleetham, John and Kasai, Takatoshi and Kimoff, R. John and Leung, Richard S. T. and Lorenzi Filho, Geraldo and Mayer, Pierre and Mielniczuk, Lisa and Morrison, Debra L. and Parati, Gianfranco and Parthasarathy, Sairam and Redolfi, Stefania and Ryan, Clodagh M. and Series, Frederic and Tomlinson, George A. and Woo, Anna and Bradley, T. Douglas (2017) Distinct Patterns of Hyperpnea During Cheyne-Stokes Respiration: Implication for Cardiac Function in Patients With Heart Failure. JOURNAL OF CLINICAL SLEEP MEDICINE, 13 (11): PII jc-17-. pp. 1235-1241. ISSN 1550-9389, 1550-9397
Full text not available from this repository. (Request a copy)Abstract
Study Objectives: In heart failure (HF), we observed two patterns of hyperpnea during Cheyne-Stokes respiration with central sleep apnea (CSR-CSA): a positive pattern where end-expiratory lung volume remains at or above functional residual capacity, and a negative pattern where it falls below functional residual capacity. We hypothesized the negative pattern is associated with worse HF. Methods: Patients with HF underwent polysomnography. During CSR-CSA, hyperpnea, apnea-hyperpnea cycle, and lung to finger circulation times (LFCT) were measured. Plasma N-terminal prohormone of brain natriuretic peptide (NT-proBNP) concentration and left ventricular ejection fraction (LVEF) were assessed. Results: Of 33 patients with CSR-CSA (31 men, mean age 68 years), 9 had a negative hyperpnea pattern. There was no difference in age, body mass index, and apnea-hypopnea index between groups. Patients with a negative pattern had longer hyperpnea time (39.5 +/- 6.4 versus 25.8 +/- 5.9 seconds, P <.01), longer cycle time (67.8 +/- 15.9 versus 51.7 +/- 9.9 seconds, P <.01), higher NT-proBNP concentrations (2740 [6769] versus 570 [864] pg/ml, P =.01), and worse New York Heart Association class (P =.02) than those with a positive pattern. LFCT and LVEF did not differ between groups. Conclusions: Patients with HF and a negative CSR-CSA pattern have evidence of worse cardiac function than those with a positive pattern. Greater positive expiratory pressure during hyperpnea is likely generated during the negative pattern and might support stroke volume in patients with worse cardiac function. Commentary: A commentary on this article appears in this issue on page 1227.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CENTRAL SLEEP-APNEA; POSITIVE AIRWAY PRESSURE; CARDIOPULMONARY RESUSCITATION; BREATHING DISORDERS; COMPRESSION; central sleep apnea; Cheyne-Stokes respiration; heart failure; hyperpnea |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 14 Dec 2018 13:01 |
| Last Modified: | 26 Feb 2019 12:06 |
| URI: | https://pred.uni-regensburg.de/id/eprint/625 |
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