PMID- 10532507
OWN - NLM
STAT- MEDLINE
DCOM- 19991102
LR  - 20190622
IS  - 0002-9149 (Print)
IS  - 0002-9149 (Linking)
VI  - 84
IP  - 8
DP  - 1999 Oct 15
TI  - Association between hemodynamic impairment and Cheyne-Stokes respiration and 
      periodic breathing in chronic stable congestive heart failure secondary to 
      ischemic or idiopathic dilated cardiomyopathy.
PG  - 900-4
AB  - Irregular breathing occurs frequently in patients with congestive heart failure 
      (CHF) both during daytime and nighttime. Many factors are involved in the genesis 
      of these breathing abnormalities, but the role of the hemodynamic impairment 
      remains controversial. This study investigated the relation between worsening 
      ventricular function and the frequency of respiratory disorders in patients with 
      mild to severe CHF. One hundred fifty patients with CHF (mean age 53 +/- 8 years, 
      left ventricular (LV) ejection fraction 26 +/- 7, in New York Heart Association 
      [NYHA] classes II to IV, and who underwent stable therapy for > or =2 weeks) were 
      studied. Analysis of instantaneous lung volume signal and arterial oxygen 
      saturation during awake daytime revealed a normal respiratory pattern in 63 
      patients, whereas 87 had a persistent alteration of breathing, with a typical 
      Cheyne-Stokes respiration (CSR) in 42 and periodic breathing (PB [oscillation of 
      tidal volumes without apnea]) in 45 patients. Patients with PB and CSR showed a 
      more pronounced hemodynamic impairment with a significantly reduced cardiac 
      index, an increased pulmonary arterial wedge pressure, and a longer lung-to-ear 
      circulation time (LECT) compared with patients with normal respiratory patterns. 
      In a logistic regression model that included all of the variables significantly 
      associated with breathing disorders, cardiac index and LECT emerged as the major 
      determinants of CSR. In those patients with LECT > or =30 seconds (upper 
      quartile) and cardiac index < or =1.9 L/min/m2 (lower quartiles), the incidence 
      of CSR was significantly higher (69%) than in patients with lower LECT and higher 
      cardiac index (14%, p <0.001). In conclusion, abnormalities of breathing activity 
      during daytime are significantly associated with a prolonged circulation time and 
      a more severe impairment of systolic and diastolic LV indexes.
FAU - Mortara, A
AU  - Mortara A
AD  - Division of Cardiology, Centro Medico di Montescano, S. Maugeri Foundation, 
      IRCCS, Pavia, Italy. andreamortara@compuserve.com
FAU - Sleight, P
AU  - Sleight P
FAU - Pinna, G D
AU  - Pinna GD
FAU - Maestri, R
AU  - Maestri R
FAU - Capomolla, S
AU  - Capomolla S
FAU - Febo, O
AU  - Febo O
FAU - La Rovere, M T
AU  - La Rovere MT
FAU - Cobelli, F
AU  - Cobelli F
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
RN  - S88TT14065 (Oxygen)
SB  - IM
MH  - Analysis of Variance
MH  - Apnea/etiology/physiopathology
MH  - Cardiomyopathy, Dilated/*complications
MH  - Cheyne-Stokes Respiration/*etiology/*physiopathology
MH  - Chi-Square Distribution
MH  - Chronic Disease
MH  - Echocardiography, Doppler
MH  - Electrocardiography
MH  - Female
MH  - Heart Failure/*etiology/*physiopathology
MH  - Hemodynamics
MH  - Humans
MH  - Logistic Models
MH  - Lung Volume Measurements
MH  - Male
MH  - Middle Aged
MH  - Oxygen/blood
MH  - Plethysmography
MH  - Pulmonary Circulation
EDAT- 1999/10/26 00:00
MHDA- 1999/10/26 00:01
CRDT- 1999/10/26 00:00
PHST- 1999/10/26 00:00 [pubmed]
PHST- 1999/10/26 00:01 [medline]
PHST- 1999/10/26 00:00 [entrez]
AID - S0002-9149(99)00462-2 [pii]
AID - 10.1016/s0002-9149(99)00462-2 [doi]
PST - ppublish
SO  - Am J Cardiol. 1999 Oct 15;84(8):900-4. doi: 10.1016/s0002-9149(99)00462-2.