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Cheynes stokes

Richard Salazar
INTRODUCTION: Sporadic Creutzfeldt-Jakob disease is a prion disease characterized by rapidly progressive dementia, ataxia and myoclonus. Atypical phenotype masquerading as stroke, movement disorders or autoimmune encephalitis have been described. Here, I report a probable case of sCJD with an atypical presentation associated with anti-Zic4 antibody and review the literature of neuronal antibodies in CJD. CASE REPORT: A 70 year-old gentleman is admitted with a 2-month history of recurrent stroke-like symptoms associated with behavioral disturbances, gait ataxia and rapidly progressive dementia...
March 5, 2018: Clinical Neurology and Neurosurgery
V Lamberts, Ph Baele, D Kahn, G Liistro
No abstract text is available yet for this article.
March 2018: Sleep Medicine
K Terziyski, A Draganova
Characterized by periodic crescendo-decrescendo pattern of breathing alternating with central apneas, Central sleep apnea (CSA) with Cheyne-Stokes Breathing represents a highly prevalent, yet underdiagnosed comorbidity in chronic heart failure (CHF). A diverse body of evidence demonstrates increased morbidity and mortality in the presence of CSB. CSB has been described in both CHF patients with preserved and reduced ejection fraction, regardless of drug treatment. Risk factors for CSB are older age, male gender, high BMI, atrial fibrillation and hypocapnia...
February 7, 2018: Advances in Experimental Medicine and Biology
Michael Arzt, Olaf Oldenburg, Andrea Graml, Erland Erdmann, Helmut Teschler, Karl Wegscheider, Anna Suling, Holger Woehrle
BACKGROUND: Different sleep-disordered breathing (SDB) phenotypes, including coexisting obstructive and central sleep apnea (OSA-CSA), have not yet been characterized in a large sample of patients with heart failure and reduced ejection fraction (HFrEF) receiving guideline-based therapies. Therefore, the aim of the present study was to determine the proportion of OSA, CSA, and OSA-CSA, as well as periodic breathing, in HFrEF patients with SDB. METHODS AND RESULTS: The German SchlaHF registry enrolled patients with HFrEF receiving guideline-based therapies, who underwent portable SDB monitoring...
November 29, 2017: Journal of the American Heart Association
Alexander Fletcher, Dominic Moor
Cheyne-Stokes respiration - an abnormal pattern of breathing, oscillating between hyperventilation and apnoea - was first described in the 19th century by Dr John Cheyne and Dr William Stokes. Although primarily known for this condition, both men contributed a lot more to the understanding and practice of medicine than this eponym.
November 2017: Journal of the Intensive Care Society
Luciano F Drager, R Doug McEvoy, Ferran Barbe, Geraldo Lorenzi-Filho, Susan Redline
Emerging research highlights the complex interrelationships between sleep-disordered breathing and cardiovascular disease, presenting clinical and research opportunities as well as challenges. Patients presenting to cardiology clinics have a high prevalence of obstructive and central sleep apnea associated with Cheyne-Stokes respiration. Multiple mechanisms have been identified by which sleep disturbances adversely affect cardiovascular structure and function. Epidemiological research indicates that obstructive sleep apnea is associated with increases in the incidence and progression of coronary heart disease, heart failure, stroke, and atrial fibrillation...
November 7, 2017: Circulation
Shahrokh Javaheri, Lee K Brown
Central sleep apnea (CSA) and Hunter-Cheyne-Stokes breathing (HCSB) are caused by failure of the pontomedullary pacemaker generating breathing rhythm. CSA/HCSB may complicate several disorders causing recurrent arousals and desaturations. Common causes of CSA in adults are congestive heart failure, stroke, and chronic use of opioids; opioids have hypoventilatory effects. Diagnosis and treatment of hyperventilatory CSA may improve quality of life, and, when associated with heart failure or cerebrovascular disease, reduce morbidity and perhaps mortality...
December 2017: Sleep Medicine Clinics
Lee K Brown, Shahrokh Javaheri
Since the introduction of continuous positive airway pressure (PAP) for the treatment of obstructive sleep apnea (OSA) in 1981, PAP technology has diversified exponentially. Compact and quiet fixed continuous PAP flow generators, autotitrating PAP devices, and bilevel PAP devices that can treat multiple sleep-disordered breathing phenotypes including OSA, central sleep apnea (CSA), combinations of OSA and CSA, and hypoventilation are available. Adaptive servo-ventilators can suppress Hunter-Cheyne-Stokes breathing and CSA and treat coexisting obstructive events...
December 2017: Sleep Medicine Clinics
Anna Heidbreder, Jens Spießhöfer, Jörg Stypmann, Matthias Boentert, Peter Young, Thomas Duning
This study investigated the association of microstructural cerebral lesions with central sleep apnea with Cheyne-Stokes-respiration (CSA-CSR) in heart failure (HF) patients and the effect of positive airway pressure therapy (PAP) of CSA-CSR on these lesions. PAP-therapy was initiated in patients with HF with midrange and with reduced ejection fraction (NYHA≥II; left ventricular ejection fraction <50%) and proven CSA-CSR. Cerebral magnetic resonance imaging (MRI) scans at 3T including diffusion tensor imaging were obtained before and after 4 months of PAP-therapy...
November 2, 2017: Respiratory Physiology & Neurobiology
Elisa Perger, Toru Inami, Owen D Lyons, Hisham Alshaer, Stephanie Smith, John S Floras, Alexander G Logan, Michael Arzt, Joaquin Duran Cantolla, Diego Delgado, Michael Fitzpatrick, John Fleetham, Takatoshi Kasai, R John Kimoff, Richard S T Leung, Geraldo Lorenzi Filho, Pierre Mayer, Lisa Mielniczuk, Debra L Morrison, Gianfranco Parati, Sairam Parthasarathy, Stefania Redolfi, Clodagh M Ryan, Frederic Series, George A Tomlinson, Anna Woo, T Douglas Bradley
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...
November 15, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Rami N Khushaba, Jeff Armitstead, Klaus Schindhelm
Monitoring of respiration patterns allows the early detection of various breathing disorders and may better identify those at risk for adverse acute outcomes in a variety of clinical settings. In this paper, we report on the use of SleepMinder (SM), a bedside non-contact Doppler-based biomotion recording sensor, to monitor remotely the nocturnal respiration patterns of 50 patients with systolic Heart failure (HF) while undergoing a lab based Polysomnography (PSG) test. A new respiration rate (RR) monitoring algorithm was developed based on the collected overnight radar signals...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Johanna Strotmann, Henrik Fox, Thomas Bitter, Odile Sauzet, Dieter Horstkotte, Olaf Oldenburg
BACKGROUND: Sleep-disordered breathing (SDB) represents a common and highly relevant co-morbidity in patients with atrial fibrillation (Afib). Obstructive sleep apnea (OSA) has been identified as an independent risk factor for developing Afib and for Afib recurrence after treatment, but the role of central sleep apnea (CSA) is less clear. This study investigated characteristics of SDB in Afib patients with preserved left ventricular ejection fraction (PEF). METHODS AND RESULTS: Consecutive patients (07/2007 to 03/2016) with documented Afib at hospital admission and PEF undergoing 6-channel cardiorespiratory polygraphy (PG) screening were retrospectively analyzed...
February 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Antonio Sanna
The Obstructive Sleep Apnea Syndrome (OSAS) consists of recurring episodes of complete or partial obstruction of the pharynx. The application of a continuous positive pressure in the airways (CPAP) is the first therapeutic option that is found to ensure complete patency of the pharynx during sleep, avoiding apneas and hypopneas with resolution of the symptoms. More recently, other devices have been proposed as OSAS treatment. The auto-CPAP has a role in finding the therapeutic value of the CPAP pressure rather than in OSAS therapy...
August 28, 2017: La Medicina del Lavoro
Aditya Badheka, Randi Durden, Veerajalandhar Allareddy
No abstract text is available yet for this article.
August 23, 2017: BMJ Case Reports
Sushma M Dharia, Lee K Brown
PURPOSE OF REVIEW: The bidirectional relationships that have been demonstrated between heart failure (HF) and central sleep apnea (CSA) demand further exploration with respect to the implications that each condition has for the other. This review discusses the body of literature that has accumulated on these relationships and how CSA and its potential treatment may affect outcomes in patients with CSA. RECENT FINDINGS: Obstructive sleep apnea (OSA) can exacerbate hypertension, type 2 diabetes, obesity, and atherosclerosis, which are known predicates of HF...
October 2017: Current Heart Failure Reports
Chiara Borrelli, Alberto Aimo, Gianluca Mirizzi, Claudio Passino, Giuseppe Vergaro, Michele Emdin, Alberto Giannoni
Introduction Despite being a risk mediator in several observational studies, central apneas are currently orphan of treatment in heart failure. After the neutral effects on survival of two randomized controlled trials (RCTs) based on the use of positive airway pressure (the CANPAP and SERVE-HF trials), two alternative hypotheses have been formulated: 1) Periodic breathing/Cheyne-Stokes respiration (PB/CSR) in HF is protective. Indeed, the Naughton's hypothesis assumes that hyperventilation leads to increased cardiac output, lung volume, oxygen storage and reduced muscle sympathetic nerve activity, while central apnea to respiratory muscle rest and hypoxia-induced erythropoiesis...
August 23, 2017: Expert Review of Cardiovascular Therapy
Lorenzo Conte, Nicola Riccardo Pugliese, Alberto Giannoni
Dyspnea and bradyarrhythmias are frequent adverse effects (AEs) of ticagrelor. AEs commonly occur within the first week of therapy, are dose related and usually mild, but sometimes they may cause drug discontinuation. Currently, the exact mechanisms of ticagrelor-related AEs have not been definitively explained. In addition to the prevalent theory of adenosine overload, other reasonable mechanisms like a direct central stimulation hypothesis was suggested. We present a case of incessant Cheyne-Stokes respiration associated with heart rate instability in patient with congestive heart failure (HF) and non-ST-segment elevation myocardial infarction (NSTEMI), supporting the use of aminophylline as a potential reversal agent of ticagrelor-related AEs...
July 12, 2017: Journal of Cardiovascular Pharmacology
Jenny J Sun, Russell S Ray
The catecholaminergic (CA) system has been implicated in many facets of breathing control and offers an important target to better comprehend the underlying etiologies of both developmental and adult respiratory pathophysiologies. Here, we used a noninvasive DREADD-based pharmacogenetic approach to acutely perturb Tg(Th-Cre)FI172Gsat (Th-Cre)-defined neurons in awake and unrestrained mice in an attempt to characterize CA function in breathing. We report that clozapine-N-oxide (CNO)-DREADD-mediated inhibition of Th-Cre-defined neurons results in blunted ventilatory responses under respiratory challenge...
August 15, 2017: Biology Open
Patricia Tung, Yamini S Levitzky, Rui Wang, Jia Weng, Stuart F Quan, Daniel J Gottlieb, Michael Rueschman, Naresh M Punjabi, Reena Mehra, Suzie Bertisch, Emelia J Benjamin, Susan Redline
BACKGROUND: Previous studies have documented a high prevalence of atrial fibrillation (AF) in individuals with obstructive sleep apnea (OSA). Central sleep apnea (CSA) has been associated with AF in patients with heart failure. However, data from prospective cohorts are sparse and few studies have distinguished the associations of obstructive sleep apnea from CSA with AF in population studies. METHODS AND RESULTS: We assessed the association of obstructive sleep apnea and CSA with incident AF among 2912 individuals without a history of AF in the SHHS (Sleep Heart Health Study), a prospective, community-based study of existing ("parent") cohort studies designed to evaluate the cardiovascular consequences of sleep disordered breathing...
July 1, 2017: Journal of the American Heart Association
Adelita Tinoco, Barbara J Drew, Xiao Hu, David Mortara, Bruce A Cooper, Michele M Pelter
BACKGROUND: Cheyne-Stokes respiration (CSR) has been investigated primarily in outpatients with heart failure. In this study we compare CSR and periodic breathing (PB) between healthy and cardiac groups. METHODS: We compared CSR and PB, measured during 24 hr of continuous 12-lead electrocardiographic (ECG) Holter recording, in a group of 90 hospitalized patients presenting to the emergency department with symptoms suggestive of acute coronary syndrome (ACS) to a group of 100 healthy ambulatory participants...
November 2017: Annals of Noninvasive Electrocardiology
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