Congestive Heart FailuresAssociation between hemodynamic impairment and cheyne-stokes respiration and periodic breathing in chronic stable congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy
Section snippets
Patient group
One hundred fifty consecutive in-patients with stable CHF (mean age 53 ± 8 years, women 13%, body mass index 25.9 ± 3.5 kg/m2) were enrolled in the study. All patients were admitted to our hospital for consideration of possible heart transplantation. They had to have a LV ejection fraction of <40% and ≥1 episode of severe cardiac decompensation in the preceding 6 months. At entry to our study all the patients were in a stable condition (no changes in signs and symptoms in the preceding 2 weeks)
Results
PB and CSR were detected respectively in 30% and 28% of the patients studied, whereas in the remaining 42% the respiratory pattern was normal. Clinical and hemodynamic characteristics of the overall population and of the 3 groups of subjects are reported in Table I. A close and linear relation exists between breathing disorders and hemodynamic impairment, particularly when considering patients with CSR (Figure 1) ; in contrast, a weak nonsignificant association seems to be present when only
Discussion
This study shows that these gross abnormalities of breathing are frequently observed during the day and are largely related to the level of hemodynamic dysfunction as expressed both by prolongation of the circulation time and by reduced cardiac index and increased pulmonary arterial wedge pressure. Other parameters that only weakly and indirectly reflect hemodynamic impairment, such as LV ejection fraction or maximal work capacity, were not significantly related to an altered pattern of
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Effects of β-blocker therapy on exercise oscillatory ventilation in reduced ejection fraction heart failure patients: A case series study
2022, Biomedicine and PharmacotherapyCitation Excerpt :Second, the circulatory delay hypothesis suggests that the prolonged circulation time from lungs to chemoreceptors and respiratory centers leads to disturbance of feedback systems [30]. Reduced cardiac index (CI) leads to increased circulation time, causing delay in the transfer of information to chemoreceptors, which in turn generates delayed feedback signals that result in imprecise control of respiration [30,31]. A direct correlation was observed between lung-to-ear circulation time with cycle length and hyperpnea length, and an inverse correlation with CI in HF patients with Cheyne-Stokes respiration [32].
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