Distinct Patterns of Hyperpnea During Cheyne-Stokes Respiration: Implication for Cardiac Function in Patients With...

Area of Science:

• Cardiology
• Sleep Medicine
• Respiratory Physiology

Background:

• Cheyne-Stokes respiration with central sleep apnea (CSR-CSA) is common in heart failure (HF).
• Two distinct hyperpnea patterns, positive and negative, have been observed during CSR-CSA based on end-expiratory lung volume relative to functional residual capacity.

Purpose of the Study:

• To investigate the association between negative hyperpnea pattern during CSR-CSA and cardiac function in patients with HF.
• To test the hypothesis that the negative pattern is linked to more severe HF.

Main Methods:

• Polysomnography was performed on 33 patients with HF and CSR-CSA.
• Hyperpnea, apnea-hyperpnea cycle duration, lung to finger circulation times (LFCT), plasma N-terminal prohormone of brain natriuretic peptide (NT-proBNP), and left ventricular ejection fraction (LVEF) were measured.

Main Results:

• Nine patients exhibited a negative hyperpnea pattern.
• Patients with the negative pattern had significantly longer hyperpnea and cycle times.
• Higher NT-proBNP concentrations and worse New York Heart Association class were observed in the negative pattern group, indicating poorer cardiac function.

Conclusions:

• A negative hyperpnea pattern during CSR-CSA in HF patients is associated with worse cardiac function.
• The negative pattern may involve greater positive expiratory pressure during hyperpnea, potentially aiding stroke volume in compromised hearts.