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Effects of cardiac dysfunction on non-hypercapnic central sleep apnea
1Department of Respiratory Medicine, Alfred Hospital, Monash University Medical School, Melbourne, Victoria, Australia.
Chest
|January 24, 1998
Summary
Central sleep apnea (CSA) in congestive heart failure (CHF) patients can be identified by specific ventilation patterns. A ventilatory length to apnea length ratio greater than 1.0 indicates CHF.
Area of Science:
- Cardiology
- Pulmonology
- Sleep Medicine
Background:
- Non-hypercapnic central sleep apnea (CSA) is common in adults with congestive heart failure (CHF) and can occur in those without CHF.
- Factors like hyperventilation, reduced lung volume, and circulatory delay contribute to CSA, with varying degrees of impact based on CHF presence.
Purpose of the Study:
- To determine if sleep ventilation patterns can identify the presence of CHF in patients with CSA.
- Investigate the relationship between ventilatory patterns and CHF status.
Main Methods:
- Analyzed full polysomnographs from 10 consecutive subjects with CHF and 10 without CHF, all exhibiting CSA.
- Measured ventilatory length, apnea length, cycle length, and circulation time during non-REM sleep.
Main Results:
- The CHF group exhibited significantly longer circulation times (24.9s vs 11.8s) and cycle lengths (69.5s vs 35.1s) compared to the non-CHF group.
- The ventilatory length to apnea length (VL:AL) ratio was consistently >1.0 in the CHF group (mean 1.65) and <1.0 in the non-CHF group (mean 0.66).
- Left ventricular ejection fraction (LVEF) negatively correlated with circulation time and cycle length.
Conclusions:
- A VL:AL ratio > 1.0 is a reliable indicator of CHF in CSA patients.
- Circulation time > 15 seconds or cycle length > 45 seconds can also identify CHF in individuals with CSA.