TY - JOUR
T1 - Effect of Cheyne-Stokes respiration on muscle sympathetic nerve activity in severe congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy
AU - Van De Borne, Philippe
AU - Oren, Ron
AU - Abouassaly, Chadi
AU - Anderson, Erling
AU - Somers, Virend K.
N1 - Funding Information:
Dr. Somers was supported by an American Heart Association Grant-in-Aid; National Institute of Health grant HL14388 and Sleep Academic Award, Bethesda, Maryland. Dr. van de Borne was supported by a Fogarty Fellowship, a Belgium NATO Research Fellowship, and a J. William Fulbright Foreign Research Fellowship.
PY - 1998/2/15
Y1 - 1998/2/15
N2 - 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.
AB - 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.
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U2 - 10.1016/S0002-9149(97)00936-3
DO - 10.1016/S0002-9149(97)00936-3
M3 - Article
C2 - 9485132
AN - SCOPUS:0032520171
SN - 0002-9149
VL - 81
SP - 432
EP - 436
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 4
ER -