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https://www.readbyqxmd.com/read/28467884/impairment-of-pulmonary-diffusion-correlates-with-hypoxemic-burden-in-central-sleep-apnea-heart-failure-patients
#1
Henrik Fox, Britta Koerber, Thomas Bitter, Dieter Horstkotte, Olaf Oldenburg
PURPOSE: Central sleep apnea (CSA) and Cheyne-Stokes respiration (CSR) are highly prevalent in heart failure (HF) and are linked to increased mortality. Impaired pulmonary diffusion capacity [DLCO] and [KCO]) have been suggested to play a key role in CSA-CSR pathophysiology. This study investigated the relationship between HF, CSR, DLCO and KCO in well-characterized HF patients. METHODS: This prospective study included HF patients with CSR, all patients underwent full overnight polysomnography (PSG) and lung function testing...
April 30, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28438369/independent-prognostic-importance-of-respiratory-instability-and-sympathetic-nerve-activity-in-patients-with-chronic-heart-failure
#2
Hidetsugu Asanoi, Daisuke Harada, Yoshitaka Oda, Hiroshi Ueno, Junya Takagawa, Hisanari Ishise, Yukiko Goso, Shuji Joho, Hiroshi Inoue
BACKGROUND: Respiratory instability in chronic heart failure (CHF) is characterized by irregularly rapid respiration or non-periodic breathing rather than by Cheyne-Stokes respiration. We developed a new quantitative measure of respiratory instability (RSI) and examined its independent prognostic impact upon CHF. METHODS: In 87 patients with stable CHF, respiratory flow and muscle sympathetic nerve activity (MSNA) were simultaneously recorded. RSI was calculated from the frequency distribution of respiratory spectral components and very low frequency components...
April 21, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28427400/monitoring-mandibular-movements-to-detect-cheyne-stokes-breathing
#3
Jean-Benoît Martinot, Jean-Christian Borel, Nhat-Nam Le-Dong, Hervé Jean-Pierre Guénard, Valerie Cuthbert, Philip E Silkoff, David Gozal, Jean-Louis Pepin
BACKGROUND: The patterns of mandibular movements (MM) during sleep can be used to identify increased respiratory effort periodic large-amplitude MM (LPM), and cortical arousals associated with "sharp" large-amplitude MM (SPM). We hypothesized that Cheyne Stokes breathing (CSB) may be identified by periodic abnormal MM patterns. The present study aims to evaluate prospectively the concordance between CSB detected by periodic MM and polysomnography (PSG) as gold-standard. The present study aims to evaluate prospectively the concordance between CSB detected by periodic MM and polysomnography (PSG) as gold-standard...
April 20, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28314626/cerebral-hemodynamic-effects-of-cheyne-stokes-respiration-in-a-patient-with-stroke
#4
R C Nogueira, R B Panerai, M J Teixeira, T G Robinson, E Bor-Seng-Shu
INTRODUCTION: Cheyne-Stokes respiration (CSR) and central sleep apnea (CSA) are common in patients with heart failure and/or stroke. We aim to describe the cerebrovascular effects of CSR during the acute phase of stroke in a heart failure patient. CASE REPORT: A 74-year-old male with previous dilated cardiomyopathy had sudden onset of right hemiparesis and aphasia. A transcranial Doppler was performed with continuous measurement of blood pressure (BP) (Finometer) and end-tidal CO2 (nasal capnography)...
March 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28220556/association-between-central-sleep-apnea-and-left-ventricular-structure-the-multi-ethnic-study-of-atherosclerosis
#5
Sogol Javaheri, Ravi K Sharma, David A Bluemke, Susan Redline
We assessed whether the presence of central sleep apnea is associated with adverse left ventricular structural changes. We analysed 1412 participants from the Multi-Ethnic Study of Atherosclerosis who underwent both overnight polysomnography and cardiac magnetic resonance imaging. Subjects had been recruited 10 years earlier when free of cardiovascular disease. Our main exposure is the presence of central sleep apnea as defined by central apnea-hypopnea index = 5 or the presence of Cheyne-Stokes breathing...
February 21, 2017: Journal of Sleep Research
https://www.readbyqxmd.com/read/28211952/long-term-experience-with-first-generation-implantable-neurostimulation-device-in-central-sleep-apnea-treatment
#6
Henrik Fox, Thomas Bitter, Dieter Horstkotte, Olaf Oldenburg, Klaus-Jürgen Gutleben
BACKGROUND: Sleep-disordered breathing (SDB) and Cheyne-Stokes respiration (CSR) are associated with shorter survival in patients with heart failure. A novel treatment method for this patient group is unilateral phrenic nerve stimulation by the remedē® system (Respicardia Inc., Minnetonka, MN, USA), a transvenously implantable neurostimulation device, which has recently been studied in a large randomized, controlled trial. Previous literature has shown efficacy and safety of the treatment with this first-generation device, but hardly any data are available on long-term clinical parameters, the remedē® device's battery lifetime, device exchangeability, lead position stability, surgical accessibility, and manageability...
May 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28188451/patients-with-cheyne-stokes-respiration-and-heart-failure-patient-tolerance-after-three-month-discontinuation-of-treatment-with-adaptive-servo-ventilation
#7
Arild Hetland, Tøri Vigeland Lerum, Kristina H Haugaa, Thor Edvardsen
The recent SERVE HF study concluded that patients with chronic heart failure (CHF) and Cheyne-Stokes respiration (CSR) have increased mortality when treated with adaptive servo-ventilation (ASV). We, therefore, wanted to explore if these patients tolerated discontinuation of ASV treatment. The study was a prospective post-ASV treatment observational design with a 3-month follow-up period. 14 patients from our outpatient clinic, all male, were originally diagnosed with CHF and Cheyne-Stokes respiration, which is a clinical form of central sleep apnea...
February 11, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28178694/resolution-of-cheyne-stokes-respiration-after-treatment-of-heart-failure-with-sacubitril-valsartan-a-first-case-report
#8
Henrik Fox, Thomas Bitter, Dieter Horstkotte, Olaf Oldenburg
Sleep-disordered breathing (SDB) is highly prevalent in patients with heart failure (HF), and is known to be associated with a worse prognosis. The severity of central sleep apnea is thought to mirror cardiac dysfunction. The novel angiotensin receptor-neprilysin inhibitor (ARNi) sacubitril has been shown to improve HF, but a relationship between treatment with ARNi and the severity of SDB has not yet been investigated. We report the case of a 71-year-old male with HF and SDB. Treatment with sacubitril/valsartan was associated with improved cardiac function, as shown by a reduction in the level of N-terminal prohormone of brain natriuretic peptide from 3,249 to 1,720 pg/mL, and an improvement in left-ventricular ejection fraction from 30 to 35%...
2017: Cardiology
https://www.readbyqxmd.com/read/28068279/identifying-predictors-of-central-sleep-apnea-cheyne-stokes-breathing-in-chronic-heart-failure-a-pathophysiological-approach
#9
Aneliya I Draganova, Kiril V Terziyski, Stefan S Kostianev
Chronic heart failure (CHF) is a major health problem associated with increased mortality, despite modern treatment options. Central sleep apnea (CSA)/Cheyne-Stokes breathing (CSB) is a common and yet largely under-diagnosed co-morbidity, adding significantly to the poor prognosis in CHF because of a number of acute and chronic effects, including intermittent hypoxia, sympathetic overactivation, disturbed sleep architecture and impaired physical tolerance. It is characterized by repetitive periods of crescendo-decrescendo ventilatory pattern, alternating with central apneas and hypopneas...
December 1, 2016: Folia Medica
https://www.readbyqxmd.com/read/27998040/sleep-apnoea-in-heart-failure-to-treat-or-not-to-treat
#10
REVIEW
Matthew T Naughton, Kirk Kee
Heart failure (HF) and sleep apnoea are common disorders which frequently coexist. Two main types of apnoea occur: one is obstructive which, through recurring episodes of snoring, hypoxaemia, large negative intra-thoracic pressures and arousals from sleep leading to downstream inflammatory and autonomic nervous system changes, is thought to be a causative factor to the development of systemic hypertension and HF. The other type of apnoea, Cheyne-Stokes respiration with central sleep apnoea (CSR-CSA), is characterized by an oscillatory pattern of ventilation with a prevailing hyperventilation-induced hypocapnia, often in the absence of significant hypoxaemia and snoring, and is thought to be a consequence of advanced HF-related low cardiac output, high sympathetic nervous system activation and pulmonary congestion...
February 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/27938912/improvements-of-central-respiratory-events-cheyne-stokes-respiration-and-oxygenation-in-patients-hospitalized-for-acute-decompensated-heart-failure
#11
Kristina Basic, Henrik Fox, Jens Spießhöfer, Thomas Bitter, Dieter Horstkotte, Olaf Oldenburg
BACKGROUND: Sleep-disordered breathing (SDB), and Cheyne-Stokes respiration (CSR) in particular, are associated with reduced survival in patients with acute decompensated heart failure (ADHF). CSR cycle length (CL) has been shown to mirror heart failure severity and therefore may be a predictor of outcome. However, studies characterizing CSR in ADHF are rare and no study has investigated changes in CSR from admission to discharge in ADHF patients. METHODS: Consecutive patients admitted to our Academic Medical Center with ADHF were eligible...
November 2016: Sleep Medicine
https://www.readbyqxmd.com/read/27896626/cheyne-stokes-respiration-during-wakefulness-in-patients-with-chronic-heart-failure
#12
Wolfram Grimm, Karl Kesper, Werner Cassel, Nina Timmesfeld, Olaf Hildebrandt, Ulrich Koehler
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...
November 28, 2016: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/27854123/a-retrospective-analysis-of-cardiovascular-outcomes-in-patients-treated-with-asv
#13
Arild Hetland, Kristina H Haugaa, Maria Vistnes, Kristian Hovde Liland, Margareth Olseng, Morten B Jacobsen, Thor Edvardsen
OBJECTIVES: The effect of long-term adaptive servo-ventilation (ASV) on cardiovascular mortality and admission rates in patients with chronic heart failure (CHF) and Cheyne-Stokes respiration (CSR) has not been much studied. The aim of this study was primarily to investigate whether ASV therapy significantly reduced these parameters. DESIGN: We included 75 CHF patients on optimal medication and CSR ≥25% of sleeping time, in New York Heart Association (NYHA) classes II-IV and left ventricular ejection fraction (LVEF) ≤ 45%...
December 7, 2016: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/27844220/respiratory-optimized-data-selection-for-more-resilient-self-navigated-whole-heart-coronary-mr-angiography
#14
Jerome Chaptinel, Davide Piccini, Gabriele Bonanno, Simone Coppo, Pierre Monney, Matthias Stuber, Juerg Schwitter
OBJECTIVES: Our objective was to test a data-exclusion strategy for respiratory motion suppression by retrospectively eliminating data acquired at extreme respiratory positions for improved coronary vessel sharpness (VS) of 1-D self-navigated 3-D radial whole-heart coronary angiography acquisitions. MATERIALS AND METHODS: 3-D radial self-navigated acquisitions were performed on a 1.5T scanner in volunteers during free-breathing (n = 8), in coached volunteers (n = 13) who were asked to breathe in a controlled manner to mimic cardiovascular patients presenting with Cheyne-Stokes breathing, and in free-breathing patients (n = 20)...
November 14, 2016: Magma
https://www.readbyqxmd.com/read/27797160/pathogenesis-of-central-and-complex-sleep-apnoea
#15
REVIEW
Jeremy E Orr, Atul Malhotra, Scott A Sands
Central sleep apnoea (CSA) - the temporary absence or diminution of ventilatory effort during sleep - is seen in a variety of forms including periodic breathing in infancy and healthy adults at altitude and Cheyne-Stokes respiration in heart failure. In most circumstances, the cyclic absence of effort is paradoxically a consequence of hypersensitive ventilatory chemoreflex responses to oppose changes in airflow, that is elevated loop gain, leading to overshoot/undershoot ventilatory oscillations. Considerable evidence illustrates overlap between CSA and obstructive sleep apnoea (OSA), including elevated loop gain in patients with OSA and the presence of pharyngeal narrowing during central apnoeas...
January 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/27707449/ventilatory-cycle-measurements-and-loop-gain-in-central-apnea-in-mining-drivers-exposed-to-intermittent-altitude
#16
Jorge Rey de Castro, Alicia Liendo, Oswaldo Ortiz, Edmundo Rosales-Mayor, César Liendo
STUDY 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 2,020 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...
January 15, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/27602681/cheyne-stokes-respiration-chemoreflex-and-ticagrelor-related-dyspnea
#17
LETTER
Alberto Giannoni, Michele Emdin, Claudio Passino
No abstract text is available yet for this article.
September 8, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27592224/mechanisms-underlying-increased-mortality-risk-in-patients-with-heart-failure-and-reduced-ejection-fraction-randomly-assigned-to-adaptive-servoventilation-in-the-serve-hf-study-results-of-a-secondary-multistate-modelling-analysis
#18
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...
November 2016: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/27587554/control-theory-prediction-of-resolved-cheyne-stokes-respiration-in-heart-failure
#19
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
https://www.readbyqxmd.com/read/27559818/resonance-as-the-mechanism-of-daytime-periodic-breathing-in-patients-with-heart-failure
#20
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 a high risk of mortality. Experimental evidence, including exaggerated ventilatory responses to 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 classic instability (Cheyne-Stokes respiration), suggesting our mechanistic understanding is limited...
January 15, 2017: American Journal of Respiratory and Critical Care Medicine
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