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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
8
pubmed:dateCreated
1999-11-2
pubmed:abstractText
Irregular breathing occurs frequently in patients with congestive heart failure (CHF) both during daytime and nighttime. Many factors are involved in the genesis of these breathing abnormalities, but the role of the hemodynamic impairment remains controversial. This study investigated the relation between worsening ventricular function and the frequency of respiratory disorders in patients with mild to severe CHF. One hundred fifty patients with CHF (mean age 53 +/- 8 years, left ventricular (LV) ejection fraction 26 +/- 7, in New York Heart Association [NYHA] classes II to IV, and who underwent stable therapy for > or =2 weeks) were studied. Analysis of instantaneous lung volume signal and arterial oxygen saturation during awake daytime revealed a normal respiratory pattern in 63 patients, whereas 87 had a persistent alteration of breathing, with a typical Cheyne-Stokes respiration (CSR) in 42 and periodic breathing (PB [oscillation of tidal volumes without apnea]) in 45 patients. Patients with PB and CSR showed a more pronounced hemodynamic impairment with a significantly reduced cardiac index, an increased pulmonary arterial wedge pressure, and a longer lung-to-ear circulation time (LECT) compared with patients with normal respiratory patterns. In a logistic regression model that included all of the variables significantly associated with breathing disorders, cardiac index and LECT emerged as the major determinants of CSR. In those patients with LECT > or =30 seconds (upper quartile) and cardiac index < or =1.9 L/min/m2 (lower quartiles), the incidence of CSR was significantly higher (69%) than in patients with lower LECT and higher cardiac index (14%, p <0.001). In conclusion, abnormalities of breathing activity during daytime are significantly associated with a prolonged circulation time and a more severe impairment of systolic and diastolic LV indexes.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Oct
pubmed:issn
0002-9149
pubmed:author
pubmed:issnType
Print
pubmed:day
15
pubmed:volume
84
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
900-4
pubmed:dateRevised
2007-11-15
pubmed:meshHeading
pubmed-meshheading:10532507-Analysis of Variance, pubmed-meshheading:10532507-Apnea, pubmed-meshheading:10532507-Cardiomyopathy, Dilated, pubmed-meshheading:10532507-Cheyne-Stokes Respiration, pubmed-meshheading:10532507-Chi-Square Distribution, pubmed-meshheading:10532507-Chronic Disease, pubmed-meshheading:10532507-Echocardiography, Doppler, pubmed-meshheading:10532507-Electrocardiography, pubmed-meshheading:10532507-Female, pubmed-meshheading:10532507-Heart Failure, pubmed-meshheading:10532507-Hemodynamics, pubmed-meshheading:10532507-Humans, pubmed-meshheading:10532507-Logistic Models, pubmed-meshheading:10532507-Lung Volume Measurements, pubmed-meshheading:10532507-Male, pubmed-meshheading:10532507-Middle Aged, pubmed-meshheading:10532507-Oxygen, pubmed-meshheading:10532507-Plethysmography, pubmed-meshheading:10532507-Pulmonary Circulation
pubmed:year
1999
pubmed:articleTitle
Association between hemodynamic impairment and Cheyne-Stokes respiration and periodic breathing in chronic stable congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy.
pubmed:affiliation
Division of Cardiology, Centro Medico di Montescano, S. Maugeri Foundation, IRCCS, Pavia, Italy. andreamortara@compuserve.com
pubmed:publicationType
Journal Article