Effect of Cheyne-Stokes respiration on muscle sympathetic nerve activity in severe congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy

Philippe Van De Borne, Ron Oren, Chadi Abouassaly, Erling Anderson, Virend K. Somers

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Severe congestive heart failure (CHF) is associated with Cheyne-Stokes (C-S) respiration, which may be an index of poorer prognosis. The mechanisms linking C-S respiration to poorer functional status and prognosis in patients with CHF are unknown. We tested the hypothesis that C-S respiration increases muscle sympathetic nerve activity (MSNA) in 9 patients with CHF. Oxygen saturation was 96 ± 1% during normal breathing and 91 ± 1% after the apneic episodes (p <0.05). Mean blood pressure was 79 ± 8 mm Hg during normal breathing and 85 ± 8 mm Hg during C-S respiration (p = 0.001). C-S respiration increased MSNA burst frequency (from 45 ± 5 bursts/min during normal breathing to 50 ± 5 bursts/min during C-S respiration; p <0.05) and total integrated nerve activity (to 117 ± 7%; p <0.05). We also studied an additional 5 patients in whom C-S breathing was constant, without any periods of spontaneous normal breathing. In these patients, MSNA was higher (65 ± 5 bursts/min) than MSNA in patients in whom C-S breathing was only intermittent (45 ± 5 bursts/min; p <0.05). In all 14 patients, the effects of different phases of C-S respiration were examined. MSNA was highest during the second half of each apnea (increasing to 152 ± 14%; p <0.01) and blood pressure was highest during mild hyperventilation occurring after termination of apnea (p <0.0001). We conclude that C-S respiration decreases oxygen saturation, increases MSNA, and induces transient elevations in blood pressure in patients with CHF.

Original languageEnglish (US)
Pages (from-to)432-436
Number of pages5
JournalAmerican Journal of Cardiology
Issue number4
StatePublished - Feb 15 1998


ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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