PMID- 17646230
OWN - NLM
STAT- MEDLINE
DCOM- 20080107
LR  - 20071113
IS  - 0012-3692 (Print)
IS  - 0012-3692 (Linking)
VI  - 132
IP  - 5
DP  - 2007 Nov
TI  - Daytime Cheyne-Stokes respiration in ambulatory patients with severe congestive 
      heart failure is associated with increased mortality.
PG  - 1463-71
AB  - BACKGROUND: Cheyne-Stokes respiration (CSR) frequently occurs in patients with 
      severe heart failure during sleep and may increase mortality. Daytime CSR 
      supposedly poses an even greater risk, but its prevalence and prognostic 
      importance remain elusive. Therefore, we investigated the circadian prevalence of 
      CSR and its influence on survival in patients with heart failure. METHODS: In 60 
      consecutive ambulatory patients (mean age+/-SE, 58.0+/-1.5 years; 6 women) with 
      stable severe heart failure (left ventricular ejection fraction, 26+/-1%; New 
      York Heart Association [NYHA] class, 2.6+/-0.1), the breathing pattern was 
      unobtrusively monitored during 24 h of usual activities with a portable 
      respiratory inductive plethysmograph. RESULTS: During nights, 62% of patients had 
      >or=15 periodic breathing cycles per hour; during days, the corresponding 
      prevalence was 16%. CSR prevailed in 32+/-3% of the night and in 10+/-2% of the 
      day, with peaks at 4:00 am, 2:00 pm, and 6:00 pm. Eighteen patients with CSR 
      during >or=10% of the daytime lived shorter without heart transplantation than 42 
      patients with <10% of daytime CSR (p<0.05) during 836+/-27 days of follow-up. CSR 
      during >or=10% of the daytime was an independent predictor of mortality (hazard 
      ratio, 3.8; 95% confidence interval, 1.1 to 12.7; p<0.05) when controlling for 
      age, sex, brain natriuretic peptide, left ventricular ejection fraction, and NYHA 
      class. CONCLUSIONS: CSR occurs in 62% of patients with severe heart failure at 
      night and in 16% during the day. Since daytime CSR is associated with reduced 
      survival, solely performing sleep studies may not allow to adequately assess 
      prognosis and tailor treatment in patients with severe heart failure.
FAU - Brack, Thomas
AU  - Brack T
AD  - Division of Pulmonary Medicine, University Hospital Zurich, Switzerland.
FAU - Thuer, Irene
AU  - Thuer I
FAU - Clarenbach, Christian F
AU  - Clarenbach CF
FAU - Senn, Oliver
AU  - Senn O
FAU - Noll, Georg
AU  - Noll G
FAU - Russi, Erich W
AU  - Russi EW
FAU - Bloch, Konrad E
AU  - Bloch KE
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20070723
PL  - United States
TA  - Chest
JT  - Chest
JID - 0231335
SB  - IM
CIN - Chest. 2007 Nov;132(5):1416-8. PMID: 17998354
MH  - Cheyne-Stokes Respiration/*mortality/*physiopathology
MH  - *Circadian Rhythm
MH  - Female
MH  - Heart Failure/*mortality/*physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Plethysmography/instrumentation
MH  - Posture
MH  - Predictive Value of Tests
MH  - Prevalence
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Risk Factors
MH  - Sleep Apnea Syndromes/*mortality/*physiopathology
EDAT- 2007/07/25 09:00
MHDA- 2008/01/08 09:00
CRDT- 2007/07/25 09:00
PHST- 2007/07/25 09:00 [pubmed]
PHST- 2008/01/08 09:00 [medline]
PHST- 2007/07/25 09:00 [entrez]
AID - S0012-3692(15)51258-0 [pii]
AID - 10.1378/chest.07-0121 [doi]
PST - ppublish
SO  - Chest. 2007 Nov;132(5):1463-71. doi: 10.1378/chest.07-0121. Epub 2007 Jul 23.