Cheyne-stokes breathing and reduced ejection fraction

The accuracy of Cheyne-Stokes breathing as a sign of left ventricular dysfunction and its overall prognostic significance are unknown.

Between 2001 and 2006, the author examined 386 inpatients at a Department of Veterans Affairs Medical Center and compared the finding of Cheyne-Stokes breathing and its cycle length with the patients' echocardiographic ejection fraction (EF) and 5-year survival.

A total of 45 of 386 patients (11.7%) had Cheyne-Stokes breathing. Two variables were independently associated with Cheyne-Stokes breathing: reduced EF (P<.001) and age>80 years (P=.006). The presence of Cheyne-Stokes breathing increased the probability of a markedly reduced EF (ie, EF<40%; likelihood ratio, 5.3; 95% confidence interval, 3.1-9), especially in patients aged≤80 years (likelihood ratio, 7.8; 95% confidence interval, 3.9-15.5). The finding was present in 1 of 3 affected patients (sensitivity=34%). The correlation between cycle length and EF was poor (r=0.23, P=.14). The 5-year survival of patients with Cheyne-Stokes breathing (37.2%) was similar to that of patients without the finding (42.9%, P=.18, log-rank test).

In hospitalized patients, Cheyne-Stokes breathing increases the probability of left ventricular dysfunction. It is present in 1 of 3 patients with markedly reduced EF. When detected during physical examination, Cheyne-Stokes breathing does not indicate worse prognosis.