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Cheynes stokes

Jorge Rey de Castro, Alicia Liendo, T Oswaldo Ortiz, Edmundo Rosales-Mayor, César Liendo
OBJECTIVES: By measuring the apnea length, ventilatory phase, respiratory cycle length, and loop gain, we can further characterize the central apneas of high altitude (CAHA). METHODS: Sixty-three drivers of all-terrain vehicles, working in a Peruvian mine located at 2020 meters above sea level (MASL), were evaluated. A respiratory polygraph was performed in the first night they slept at high altitude. None of the subjects were exposed to oxygen during the test or acetazolamide in the preceding days of the test...
September 29, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Alberto Giannoni, Michele Emdin, Claudio Passino
No abstract text is available yet for this article.
September 8, 2016: New England Journal of Medicine
Christine Eulenburg, Karl Wegscheider, Holger Woehrle, Christiane Angermann, Marie-Pia d'Ortho, Erland Erdmann, Patrick Levy, Anita K Simonds, Virend K Somers, Faiez Zannad, Helmut Teschler, Martin R Cowie
BACKGROUND: A large randomised treatment trial (SERVE-HF) showed that treatment of central sleep apnoea with adaptive servoventilation in patients with heart failure and reduced ejection fraction (HFREF) increased mortality, although the analysis of the composite primary endpoint (time to first event of death from any cause, life-saving cardiovascular intervention, or unplanned hospital admission for worsening heart failure) was neutral. This secondary multistate modelling analysis of SERVE-HF data investigated associations between adaptive servoventilation and individual components of the primary endpoint to try to better understand the mechanisms underlying the observed increased mortality...
August 31, 2016: Lancet Respiratory Medicine
Scott A Sands, Bradley A Edwards, Kirk Kee, Christopher Stuart-Andrews, Elizabeth M Skuza, Teanau Roebuck, Anthony Turton, Garun S Hamilton, Matthew T Naughton, Philip J Berger
Cheyne-Stokes respiration (CSR) foretells deleterious outcomes in patients with heart failure. Currently, the size of therapeutic intervention is not guided by the patient's underlying pathophysiology. In theory, the intervention needed to resolve CSR, as a control system instability (loop gain >1), can be predicted knowing the baseline loop gain and how much it falls with therapy.In 12 patients with heart failure, we administered an inspiratory carbon dioxide fraction of 1-3% during CSR (n=95 interventions) as a means to reduce loop gain...
September 1, 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Scott A Sands, Yoseph Mebrate, Bradley A Edwards, Shamim Nemati, Charlotte H Manisty, Akshay S Desai, Andrew Wellman, Keith Willson, Darrel P Francis, James P Butler, Atul Malhotra
RATIONALE: In patients with chronic heart failure, daytime oscillatory breathing at rest is associated with high mortality risk. Experimental evidence, including exaggerated ventilatory responses to carbon dioxide (CO2) and prolonged circulation time, implicates the ventilatory control system and suggests feedback instability (loop gain>1) is responsible. However, daytime oscillatory patterns often appear remarkably irregular versus classical instability (Cheyne-Stokes respiration), suggesting our mechanistic understanding is limited...
August 25, 2016: American Journal of Respiratory and Critical Care Medicine
Anna Kazimierczak, Paweł Krzesiński, Grzegorz Gielerak, Beata Uziębło-Życzkowska, Paweł Smurzyński, Robert Ryczek, Andrzej Cwetsch, Andrzej Skrobowski
BACKGROUND Advanced heart failure (HF) is commonly accompanied by central sleep apnea (CSA) with Cheyne-Stokes respiration (CSR). The aim of this study was to evaluate the relationship between CSA/CSR and other clinical features of HF, with particular emphasis on cardiovascular hemodynamics. MATERIAL AND METHODS In 161 stable HF patients with left ventricular ejection fraction (LVEF) ≤45% (NYHA class I-III; mean LVEF 32.8%) the clinical evaluation included: LVEF; left and right ventricular end-diastolic diameter (LVDd, RVDd); ratio of early transmitral flow velocity to early diastolic septal mitral annulus velocity (E/e') assessed by echocardiography; stroke index (SI); heart rate (HR); cardiac index (CI); and systemic vascular resistance index (SVRI) assessed by impedance cardiography (ICG)...
2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Mengmei Wang, Hao Ding, Jing Kang, Ke Hu, Wen Lu, Xiufang Zhou, Lifang Xu
BACKGROUND: CSR-CSA is frequent in patients with CHF. Dilated cardiomyopathy (DCM) is a structural heart disease with strong genetic background, yet one of the leading etiological causes of CHF. Studies have showed that the HSPB7 gene is associated with DCM. OBJECTIVES: We aimed to explore the prevalence of polymorphisms of the HSPB7 gene in the Chinese Han population with CSR-CSA and CHF caused by DCM. METHODS: A total of 503 unrelated subjects of the Chinese Han population, including 283 CHF patients caused by DCM and 220 healthy controls, were involved in the study...
October 15, 2016: International Journal of Cardiology
Takuji Toyama, Hiroshi Hoshizaki, Shu Kasama, Yusuke Miyaishi, Hakuken Kan, Eiji Yamashita, Ren Kawaguti, Hitoshi Adachi, Shigeru Ohsima
PURPOSE: Adaptive servo-ventilation (ASV) therapy has been reported to be effective for improving central sleep apnea (CSA) and chronic heart failure (CHF). The purpose of this study was to clarify whether ASV is effective for CSA, cardiac sympathetic nerve activity (CSNA), cardiac symptoms/function, and exercise capacity in CHF patients with CSA and Cheyne-Stokes respiration (CSR-CSA). METHODS: In this study, 31 CHF patients with CSR-CSA and a left ventricular ejection fraction (LVEF) ≤ 40% were randomized into an ASV group and a conservative therapy (non-ASV) group for 6 month...
July 7, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Margareth W Olseng, Brita F Olsen, Arild Hetland, May S Fagermoen, Morten Jacobsen
AIMS AND OBJECTIVES: The aim of this study was to investigate if quality of life improved in chronic heart failure patients with Cheyne-Stokes respiration treated with adaptive servo-ventilation in nurse-led heart failure clinic. BACKGROUND: Cheyne-Stokes respiration is associated with decreased quality of life in patients with chronic heart failure. Adaptive servo-ventilation is introduced to treat this sleep-disordered breathing. DESIGN: Randomized, controlled design...
June 6, 2016: Journal of Clinical Nursing
Tarek Bekfani, William T Abraham
Central sleep apnoea (CSA) occurs in ∼30-50% of patients with heart failure (HF) with reduced left ventricular ejection fraction (LVEF) and in as much as in 18-30% of patients with preserved LVEF. In HF patients, it is characterized by periodic breathing also known as the Cheyne-Stokes respiration followed by pauses of breathing. Central sleep apnoea remains often unrecognized due to its chronic and insidious incidences. Patients may report excessive daytime somnolence, poor sleep quality, nocturnal angina, recurrent arrhythmias, refractory HF symptoms, or demonstrate abnormal respiratory pattern or apnoeas...
August 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Lucas M Donovan, Vishesh K Kapur
STUDY OBJECTIVES: Determine the prevalence of central sleep apnea (CSA) in a large community-based cohort using current definitions and contrast the clinical characteristics of subjects with CSA to those with obstructive sleep apnea (OSA) and no sleep apnea. METHODS: A cross sectional analysis of baseline data from 5,804 participants of the Sleep Heart Health study was performed. Subjects meeting contemporary diagnostic criteria for CSA and Cheyne Stokes respiration (CSR) were compared to those without sleep apnea and those with OSA...
2016: Sleep
Suhail Al-Saleh, Paul F Kantor, Indra Narang
Sleep disordered breathing is well described in adults with heart failure but not in pediatric population. We describe a 13-year-old Caucasian male with severe heart failure related to dilated cardiomyopathy who demonstrated polysomnographic features of Cheyne-Stokes respiration, which completely resolved following cardiac transplantation. Cheyne-Stokes respiration in children with advanced heart failure and its resolution after heart transplant can be observed similar to adults.
2016: Case Reports in Pediatrics
Hyunju Yang, Amy M Sawyer
To summarize the current evidence for adaptive servo ventilation (ASV) in Cheyne-Stokes respiration (CSR) with central sleep apnea (CSA) in heart failure (HF) and advance a research agenda and clinical considerations for ASV-treated CSR-CSA in HF. CSR-CSA in HF is associated with higher overall mortality, worse outcomes and lower quality of life (QOL) than HF without CSR-CSA. Five databases were searched using key words (n = 234). Randomized controlled trials assessed objective sleep quality, cardiac, and self-reported outcomes in adults (≥18 years) with HF (n = 10)...
May 2016: Heart & Lung: the Journal of Critical Care
Mihaela Hubatsch, Harald Englert, Ulrich Wagner
Cheyne-Stokes respiration (CSR) is a form of sleep-disordered breathing characterised by recurrent central sleep apnoea alternating with a crescendo-decrescendo pattern of tidal volume, relatively rare observation in sleep labs. It is mainly seen in severe heart failure and stroke. We report the case of a young man with CSR after sudden onset of seizure in the context of hypertensive exacerbation leading to the diagnosis of a leukoencephalopathy, and comment on differential diagnoses, prognostic and therapeutic outcomes...
January 30, 2016: Ideggyógyászati Szemle
Scott A Sands, Robert L Owens
Congestive heart failure (CHF) is among the most common causes of admission to hospitals in the United States, especially in those over age 65. Few data exist regarding the prevalence CHF of Cheyne-Stokes respiration (CSR) owing to congestive heart failure in the intensive care unit (ICU). Nevertheless, CSR is expected to be highly prevalent among those with CHF. Treatment should focus on the underlying mechanisms by which CHF increases loop gain and promotes unstable breathing. Few data are available to determine prevalence of CSR in the ICU, or how CSR might affect clinical management and weaning from mechanical ventilation...
March 2016: Sleep Medicine Clinics
Irena Flinta, Piotr Ponikowski
Central sleep apnea (CSA) in patients with heart failure (HF) occurs frequently and shows a serious influence on prognosis in this population. The key elements in the pathophysiology of CSA are respiratory instability with chronic hyperventilation, changes of arterial carbon dioxide pressure (pCO2) and elongated circulation time. The main manifestation of CSA in patients with HF is Cheyne-Stokes Respiration (CSR). The initial treatment is the optimization of HF therapy. However, many other options of the therapeutic management have been studied, particularly those based on positive airway pressure methods...
March 2016: International Journal of Cardiology
Ugo Corrà
Ventilation inefficiency has become a matter of interest for heart failure (HF) specialists, the most remarkable being exertional oscillatory ventilation (EOV). EOV is an abnormal ventilatory phenomenon, originally described as anecdotal, but now considered a marker of disease severity and worst prognosis in HF. EOV is a cyclic fluctuation of minute ventilation (VE) and expired gas kinetics occurring during exercise: it is a slow, prominent, consistent rather than random, fluctuation in VE that may be evanescent or transient and can follow several distinct patterns...
March 2016: International Journal of Cardiology
Dominik Linz, Henrik Fox, Thomas Bitter, Jens Spießhöfer, Christoph Schöbel, Erik Skobel, Anke Türoff, Michael Böhm, Martin R Cowie, Michael Arzt, Olaf Oldenburg
Sleep disordered breathing (SDB) (obstructive sleep apnea, central sleep apnea/Cheyne-Stokes respiration or the combination of both) is highly prevalent in patients with a wide variety of cardiovascular diseases including hypertension, arrhythmia, coronary artery disease, myocardial infarction and stroke (reviewed previously in the September issue of this journal). Its close association with outcomes in chronic heart failure with reduced ejection fraction (HF-REF) suggests that it may be a potential treatment target...
July 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Béla Faludi, Beáta Bóné, Sámuel Komoly, József Janszky
The importance of the sleep related breathing disorders (obstructive sleep apnea syndrome, central sleep apnea, and Cheyne-Stokes breathing) in the pathophysiology crebro- and cardiovascular disorders is well known. The relationship of sleep related breathing abnormalities and epilepsy is also important but underestimated in the daily practice. The relation is bidirectional. The breathing abnormalities in sleep may play important role in generating epileptic seizure, but the adverse effect of seizure and antiepileptic therapy (generation of apneas and hypopneas) may worsen the seizure control...
November 30, 2015: Ideggyógyászati Szemle
Thomas Bitter, Henrik Fox, Heidi Schmalgemeier, Birgit Wellmann, Andrea Zwenke, Jens Spiesshöfer, Zisis Dimitriadis, Dieter Horstkotte, Olaf Oldenburg
OBJECTIVES: This randomized, controlled trial aimed to investigate whether acute improvement of pulmonary congestion would reduce the severity of Cheyne-Stokes respiration (CSR) in patients with chronic heart failure (CHF). METHODS: Twenty-one consecutive patients with CHF and CSR (apnea-hypopnea index [AHI] ≥15/h) underwent right heart catheterization with titration of intravenous (IV) glyceryltrinitrate (GTN) to a maximum tolerable dosage and inhalation of iloprost 10 μg/mL after a washout phase...
May 2016: Sleep & Breathing, Schlaf & Atmung
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