R. Tkacova et al., LEFT-VENTRICULAR VOLUME IN PATIENTS WITH HEART-FAILURE AND CHEYNE-STOKES RESPIRATION DURING SLEEP, American journal of respiratory and critical care medicine, 156(5), 1997, pp. 1549-1555
Citations number
37
Categorie Soggetti
Emergency Medicine & Critical Care","Respiratory System
In patients with congestive heart failure (CHF), elevated, left ventri
cular (LV) volume might lead to pulmonary congestion and hypocapnia, w
hich would create a predisposition to the development of Cheyne-Stokes
respiration with central sleep apnea (CSR-CSA). In addition, because
LV volume affects cardiac output, it should influence the lengths of h
yperpneas. We therefore evaluated LV volumes and transcutaneous PCO2 (
PtcCO(2)) during wakefulness and stage 2 sleep in 16 patients with CHF
due to nonischemic dilated cardiomyopathy (NIDC). Data were then comp
ared between those with (n = 7) and those without CSR-CSA (n = 9). LV
end-diastolic volume (LVEDV) was significantly higher in patients with
than those without CSR-CSA (585 +/- 118 versus 312 +/- 41 ml, p < 0.0
5). Compared with patients without CSR-CSA, those with CSR-CSA had low
er mean stage 2 sleep PtcCO(2) (36.3 +/- 2.2 versus 41.2 +/- 1.2 mm Hg
, p < 0.05) and a lesser change in PtcCO(2) from wakefulness to stage
2 sleep (-0.4 +/- 0.3 versus 2.0 +/- 0.4 mm Hg, p < 0.001). Among pati
ents with CSR-CSA, hyperpnea length was inversely related to LVEDV (R
= 0.769, p = 0.043) owing to the direct relationship of cardiac output
to LVEDV (R = 0.791, p = 0.034). We conclude that CSR-CSA in patients
with CHF due to NIDC is associated with increased LV volumes possibly
through the direct or indirect influence of LV volume on Pa-CO2 and c
ardiac output.