Cheyne-stokes Respiration During Wakefulness in Patients with Chronic Heart Failure

Overview

Journal Sleep Breath

Publisher Springer

Date 2016 Nov 30

PMID 27896626

Citations 2

Authors

Wolfram Grimm

Karl Kesper

Werner Cassel

Nina Timmesfeld

Olaf Hildebrandt

Ulrich Koehler

Affiliations

Soon will be listed here.

Abstract

Purpose: Cheyne-Stokes respiration (CSR) during sleep has been studied extensively in patients with chronic heart failure (CHF). Prevalence and prognostic significance of CSR during wakefulness in CHF, however, are largely unknown.

Methods: CSR during wakefulness with an apnea-hypopnea cut-off ≥5/h and moderate to severe CSR with an apnea-hypopnea cutoff ≥15/h were analyzed using polysomnographic recordings in 267 patients with stable CHF with reduced left ventricular (LV) ejection fraction at our institution. Primary endpoint during follow-up was heart transplant-free survival.

Results: Fifty of 267 patients (19%) had CSR during wakefulness and 73 of 267 patients (27%) had CSR during sleep. CSR during wakefulness was associated with advanced age, atrial fibrillation, decreased LV ejection fraction, increased LV end-diastolic diameter, brain natriuretic peptide, New York Heart Failure class, and CSR during sleep. During 43 months mean follow-up, 67 patients (25%) died and 4 patients (1%) underwent heart transplantation. Multivariate Cox analysis identified age, male gender, chronic kidney disease, and LV ejection fraction as predictors of reduced transplant-free survival. CSR during wakefulness with an apnea-hypopnea cutoff ≥5/h as well as moderate to severe CSR while awake using an apnea-hypopnea cutoff ≥15/h did not predict reduced transplant-free survival independently from confounding factors.

Conclusion: CSR during wakefulness appears to be a marker of heart failure severity.

Citing Articles

Characteristics and circadian distribution of cardiac arrhythmias in patients with heart failure and sleep-disordered breathing.

Omran H, Bitter T, Horstkotte D, Oldenburg O, Fox H Clin Res Cardiol. 2018; 107(10):965-974.

PMID: 29740701 DOI: 10.1007/s00392-018-1269-4.

Bidirectional Cardio-Respiratory Interactions in Heart Failure.

Radovanovic N, Pavlovic S, Milasinovic G, Kircanski B, Platisa M Front Physiol. 2018; 9:165.

PMID: 29559923 PMC: 5845639. DOI: 10.3389/fphys.2018.00165.

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