Circulation. 2003;107:1822-1826
doi: 10.1161/01.CIR.0000061758.05044.64
doi: 10.1161/01.CIR.0000061758.05044.64
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Circulation. 2003;107:1822.)
© 2003 American Heart Association, Inc.
Special Review |
Sleep Apnea and Heart Failure
Part II: Central Sleep Apnea
From the University of Toronto Centre for Sleep Medicine and Circadian Biology (T.D.B., J.S.F.), the Cardiopulmonary Sleep Disorders and Research Centre of the Toronto General Hospital/University Health Network (T.D.B.) and the Toronto Rehabilitation Institute (T.D.B.), and the Departments of Medicine of the University Health Network and Mount Sinai Hospital (T.D.B., J.S.F.), Toronto, Ontario, Canada.
Correspondence to T. Douglas Bradley, MD, Toronto General Hospital/University Health Network, NU 9-112, 200 Elizabeth St, Toronto, ON, M5G 2C4, Canada. E-mail douglas.bradley@utoronto.ca
Key Words: heart failure • respiration • morbidity
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
 |
Introduction |
|---|
In the first part of this 2-part review, we provided a synopsis of the cardiovascular effects of normal sleep and an overview of the diagnostic, pathophysiological, and therapeutic implications of obstructive sleep apnea (OSA) in the setting of heart failure (HF). In this second part, we turn our attention to central sleep apnea (CSA), commonly referred to as Cheyne-Stokes respiration. This breathing disorder has a strikingly higher prevalence in patients with HF as compared with the general population with normal left ventricular function, and when present appears to have adverse prognostic implications. Our objective in Part II of this review is to provide a broad perspective of the pathophysiological and clinical significance of CSA in HF.
|
Pathophysiology |
|---|
CSA associated with Cheyne-Stokes respiration is a form of periodic breathing in which central apneas and hypopneas alternate with periods of hyperventilation that have a waxing-waning pattern of tidal volume. Figure 1 illustrates the proposed mechanisms that underlie periodic oscillations in ventilation in HF. Unlike OSA, CSA likely arises as a consequence of HF. Thus, the presence of CSA may alert the physician to the necessity of intensifying HF therapy. The current debate is whether CSA is simply a reflection of severely compromised cardiac function with elevated left ventricular filling pressures, or whether, for the same degree of cardiac dysfunction, CSA exerts unique and independent pathological effects on the failing myocardium. Although there are not yet sufficient data to resolve this controversy within the confines of this review, we will discuss evidence on both
This article has been cited by other articles:
 |
|
 |
|
  T. A. Martino and M. J. Sole Molecular Time: An Often Overlooked Dimension to Cardiovascular Disease Circ. Res., November 20, 2009; 105(11): 1047 - 1061. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Triposkiadis, G. Karayannis, G. Giamouzis, J. Skoularigis, G. Louridas, and J. Butler The sympathetic nervous system in heart failure physiology, pathophysiology, and clinical implications. J. Am. Coll. Cardiol., November 3, 2009; 54(19): 1747 - 1762. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. R. Goldberg Stressful sleeping. J. Am. Coll. Cardiol., October 27, 2009; 54(18): 1713 - 1714. [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Mebrate, K. Willson, C. H. Manisty, R. Baruah, J. Mayet, A. D. Hughes, K. H. Parker, and D. P. Francis Dynamic CO2 therapy in periodic breathing: a modeling study to determine optimal timing and dosage regimes J Appl Physiol, September 1, 2009; 107(3): 696 - 706. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Fleischmann, G. Fillafer, H. Matterer, F. Skrabal, and P. Kotanko Prevalence of chronic kidney disease in patients with suspected sleep apnoea Nephrol. Dial. Transplant., August 12, 2009; (2009) gfp403v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. L. Verrier and M. E. Josephson Impact of Sleep on Arrhythmogenesis Circ Arrhythm Electrophysiol, August 1, 2009; 2(4): 450 - 459. [Full Text] [PDF]
|
|
|
|
 |
|
 J S Floras Should sleep apnoea be a specific target of therapy in chronic heart failure? Heart, July 1, 2009; 95(13): 1041 - 1046. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D Yumino, H Wang, J S Floras, G E Newton, S Mak, P Ruttanaumpawan, J D Parker, and T D Bradley Relationship between sleep apnoea and mortality in patients with ischaemic heart failure Heart, May 1, 2009; 95(10): 819 - 824. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Luthje, B. Renner, R. Kessels, D. Vollmann, T. Raupach, B. Gerritse, S. Tasci, J. O. Schwab, M. Zabel, D. Zenker, et al. Cardiac resynchronization therapy and atrial overdrive pacing for the treatment of central sleep apnoea Eur J Heart Fail, March 1, 2009; 11(3): 273 - 280. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. D. Pinna, R. Maestri, A. Mortara, P. Johnson, D. Andrews, P. Ponikowski, T. Witkowski, E. Robbi, M. T. La Rovere, and P. Sleight Pathophysiological and clinical relevance of simplified monitoring of nocturnal breathing disorders in heart failure patients Eur J Heart Fail, March 1, 2009; 11(3): 264 - 272. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Szyszko, C. Franceschini, and J. Gonzalez-Zuelgaray Reliability of a Holter-based methodology for evaluation of sleep apnoea syndrome Europace, January 1, 2009; 11(1): 94 - 99. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Sredniawa, R. Lenarczyk, O. Kowalski, P. Pruszkowska-Skrzep, J. Kowalczyk, A. Musialik-Lydka, S. Cebula, and Z. Kalarus Sleep apnoea as a predictor of mid- and long-term outcome in patients undergoing cardiac resynchronization therapy Europace, January 1, 2009; 11(1): 106 - 114. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Jayaraman, H. Sharafkhaneh, M. Hirshkowitz, and A. Sharafkhaneh Review: Pharmacotherapy of obstructive sleep apnea Therapeutic Advances in Respiratory Disease, December 1, 2008; 2(6): 375 - 386. [Abstract] [PDF]
|
|
|
|
 |
|
 V. K. Somers, D. P. White, R. Amin, W. T. Abraham, F. Costa, A. Culebras, S. Daniels, J. S. Floras, C. E. Hunt, L. J. Olson, et al. Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement From the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health) Circulation, September 2, 2008; 118(10): 1080 - 1111. [Full Text] [PDF]
|
|
|
|
 |
|
 E. Ritz Nephrology Potpourri Clin. J. Am. Soc. Nephrol., September 1, 2008; 3(5): 1253 - 1259. [Full Text] [PDF]
|
|
|
|
|
|
E. N. Simantirakis, S. E. Schiza, N. S. Siafakas, and P. E. Vardas Sleep-disordered breathing in heart failure and the effect of cardiac resynchronization therapy Europace, September 1, 2008; 10(9): 1029 - 1033. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. K. Somers, D. P. White, R. Amin, W. T. Abraham, F. Costa, A. Culebras, S. Daniels, J. S. Floras, C. E. Hunt, L. J. Olson, et al. Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement From the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health) J. Am. Coll. Cardiol., August 19, 2008; 52(8): 686 - 717. [Full Text] [PDF]
|
|
|
|
 |
|
 L. C. McKay and J. L. Feldman Unilateral Ablation of Pre-Botzinger Complex Disrupts Breathing during Sleep but Not Wakefulness Am. J. Respir. Crit. Care Med., July 1, 2008; 178(1): 89 - 95. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. A. Martino, G. Y. Oudit, A. M. Herzenberg, N. Tata, M. M. Koletar, G. M. Kabir, D. D. Belsham, P. H. Backx, M. R. Ralph, and M. J. Sole Circadian rhythm disorganization produces profound cardiovascular and renal disease in hamsters Am J Physiol Regulatory Integrative Comp Physiol, May 1, 2008; 294(5): R1675 - R1683. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. M. Ryan, S. Juvet, R. Leung, and T. D. Bradley Timing of Nocturnal Ventricular Ectopy in Heart Failure Patients With Sleep Apnea Chest, April 1, 2008; 133(4): 934 - 940. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. J. Olson, A. M. Arruda-Olson, V. K. Somers, C. G. Scott, and B. D. Johnson Exercise Oscillatory Ventilation*: Instability of Breathing Control Associated With Advanced Heart Failure Chest, February 1, 2008; 133(2): 474 - 481. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J Amit Benjamin and K E Lewis Sleep-disordered breathing and cardiovascular disease Postgrad. Med. J., January 1, 2008; 84(987): 15 - 22. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. T. La Rovere, G. D. Pinna, R. Maestri, E. Robbi, A. Mortara, F. Fanfulla, O. Febo, and P. Sleight Clinical relevance of short-term day-time breathing disorders in chronic heart failure patients Eur J Heart Fail, September 1, 2007; 9(9): 949 - 954. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. A. Martino, N. Tata, G. A. Bjarnason, M. Straume, and M. J. Sole Diurnal protein expression in blood revealed by high throughput mass spectrometry proteomics and implications for translational medicine and body time of day Am J Physiol Regulatory Integrative Comp Physiol, September 1, 2007; 293(3): R1430 - R1437. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. J. Olson and V. K. Somers Treating Central Sleep Apnea in Heart Failure: Outcomes Revisited Circulation, June 26, 2007; 115(25): 3140 - 3142. [Full Text] [PDF]
|
|
|
|
|
|
A. Noda, H. Izawa, H. Asano, S. Nakata, A. Hirashiki, Y. Murase, S. Iino, K. Nagata, T. Murohara, Y. Koike, et al. Beneficial Effect of Bilevel Positive Airway Pressure on Left Ventricular Function in Ambulatory Patients With Idiopathic Dilated Cardiomyopathy and Central Sleep Apnea-Hypopnea: A Preliminary Study Chest, June 1, 2007; 131(6): 1694 - 1701. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. A. Martino, N. Tata, D. D. Belsham, J. Chalmers, M. Straume, P. Lee, H. Pribiag, N. Khaper, P. P. Liu, F. Dawood, et al. Disturbed Diurnal Rhythm Alters Gene Expression and Exacerbates Cardiovascular Disease With Rescue by Resynchronization Hypertension, May 1, 2007; 49(5): 1104 - 1113. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Wang, J. D. Parker, G. E. Newton, J. S. Floras, S. Mak, K.-L. Chiu, P. Ruttanaumpawan, G. Tomlinson, and T. D. Bradley Influence of Obstructive Sleep Apnea on Mortality in Patients With Heart Failure J. Am. Coll. Cardiol., April 17, 2007; 49(15): 1625 - 1631. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. M. Luks and E. R. Swenson Travel to high altitude with pre-existing lung disease Eur. Respir. J., April 1, 2007; 29(4): 770 - 792. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Oldenburg, B. Lamp, L. Faber, H. Teschler, D. Horstkotte, and V. Topfer Sleep-disordered breathing in patients with symptomatic heart failure A contemporary study of prevalence in and characteristics of 700 patients Eur J Heart Fail, March 1, 2007; 9(3): 251 - 257. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. H. Manisty, K. Willson, R. Wensel, Z. I. Whinnett, J. E. Davies, W. L. G. Oldfield, J. Mayet, and D. P. Francis Development of respiratory control instability in heart failure: a novel approach to dissect the pathophysiological mechanisms J. Physiol., November 15, 2006; 577(1): 387 - 401. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Torchio, C. Gulotta, P. Greco-Lucchina, A. Perboni, L. Avonto, H. Ghezzo, and J. Milic-Emili Orthopnea and tidal expiratory flow limitation in chronic heart failure. Chest, August 1, 2006; 130(2): 472 - 479. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Ferreira, J. Winck, P. Bettencourt, and F. Rocha-Goncalves Heart failure and sleep apnoea: To sleep perchance to dream Eur J Heart Fail, May 1, 2006; 8(3): 227 - 236. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C Philippe, M Stoica-Herman, X Drouot, B Raffestin, P Escourrou, L Hittinger, P-L Michel, S Rouault, and M-P d'Ortho Compliance with and effectiveness of adaptive servoventilation versus continuous positive airway pressure in the treatment of Cheyne-Stokes respiration in heart failure over a six month period Heart, March 1, 2006; 92(3): 337 - 342. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. P. Ribeiro Periodic Breathing in Heart Failure: Bridging the Gap Between the Sleep Laboratory and the Exercise Laboratory Circulation, January 3, 2006; 113(1): 9 - 10. [Full Text] [PDF]
|
|
|
|
|
|
U. Corra, M. Pistono, A. Mezzani, A. Braghiroli, A. Giordano, P. Lanfranchi, E. Bosimini, M. Gnemmi, and P. Giannuzzi Sleep and Exertional Periodic Breathing in Chronic Heart Failure: Prognostic Importance and Interdependence Circulation, January 3, 2006; 113(1): 44 - 50. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. E. Young The circadian clock within the heart: potential influence on myocardial gene expression, metabolism, and function Am J Physiol Heart Circ Physiol, January 1, 2006; 290(1): H1 - H16. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. I. Pack Advances in Sleep-disordered Breathing Am. J. Respir. Crit. Care Med., January 1, 2006; 173(1): 7 - 15. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Unterberg, L. Luthje, J. Szych, D. Vollmann, G. Hasenfuss, and S. Andreas Atrial overdrive pacing compared to CPAP in patients with obstructive sleep apnoea syndrome Eur. Heart J., December 1, 2005; 26(23): 2568 - 2575. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Spaak, Z. J. Egri, T. Kubo, E. Yu, S.-I. Ando, Y. Kaneko, K. Usui, T. D. Bradley, and J. S. Floras Muscle Sympathetic Nerve Activity During Wakefulness in Heart Failure Patients With and Without Sleep Apnea Hypertension, December 1, 2005; 46(6): 1327 - 1332. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. D. Bradley, A. G. Logan, R. J. Kimoff, F. Series, D. Morrison, K. Ferguson, I. Belenkie, M. Pfeifer, J. Fleetham, P. Hanly, et al. Continuous Positive Airway Pressure for Central Sleep Apnea and Heart Failure. N. Engl. J. Med., November 10, 2005; 353(19): 2025 - 2033. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. S. T. Leung, M. E. Bowman, T. M. Diep, G. Lorenzi-Filho, J. S. Floras, and T. D. Bradley Influence of Cheyne-Stokes respiration on ventricular response to atrial fibrillation in heart failure J Appl Physiol, November 1, 2005; 99(5): 1689 - 1696. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Y. A. Foo, S. J. Wilson, A. P. Bradley, G. R. Williams, M.-A. Harris, and D. M. Cooper Use of Pulse Transit Time To Distinguish Respiratory Events From Tidal Breathing in Sleeping Children Chest, October 1, 2005; 128(4): 3013 - 3019. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Luthje, C. Unterberg-Buchwald, D. Dajani, D. Vollmann, G. Hasenfuss, and S. Andreas Atrial Overdrive Pacing in Patients with Sleep Apnea with Implanted Pacemaker Am. J. Respir. Crit. Care Med., July 1, 2005; 172(1): 118 - 122. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Skobel, C. Norra, A. Sinha, C. Breuer, P. Hanrath, and C. Stellbrink Impact of sleep-related breathing disorders on health-related quality of life in patients with chronic heart failure Eur J Heart Fail, June 1, 2005; 7(4): 505 - 511. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Series, R. J. Kimoff, D. Morrison, M. H. Leblanc, M. Smilovitch, J. Howlett, A. G. Logan, J. S. Floras, and T. D. Bradley Prospective Evaluation of Nocturnal Oximetry for Detection of Sleep-Related Breathing Disturbances in Patients With Chronic Heart Failure Chest, May 1, 2005; 127(5): 1507 - 1514. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Kaye and M. Esler Sympathetic neuronal regulation of the heart in aging and heart failure Cardiovasc Res, May 1, 2005; 66(2): 256 - 264. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J-L. Pepin, P. Defaye, S. Garrigue, Y. Poezevara, and P. Levy Overdrive atrial pacing does not improve obstructive sleep apnoea syndrome Eur. Respir. J., February 1, 2005; 25(2): 343 - 347. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M. Ryan and T. D. Bradley Periodicity of Obstructive Sleep Apnea in Patients With and Without Heart Failure Chest, February 1, 2005; 127(2): 536 - 542. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Bordier, S. Garrigue, S. Reuter, P. Bordachar, and J. Clementy Death During Polysomnography of a Patient With Cheyne-Stokes Respiration, Respiratory Acidosis, and Chronic Heart Failure Chest, November 1, 2004; 126(5): 1698 - 1700. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Mortara, G. D. Pinna, P. Johnson, H. Dargie, M. T. La Rovere, P. Ponikowski, L. Tavazzi, P. Sleight, and on behalf of HHH Investigators A multi-country randomised trial of the role of a new telemonitoring system in CHF: the HHH study (Home or Hospital in Heart Failure). Rational, study design and protocol Eur. Heart J. Suppl., November 1, 2004; 6(suppl_F): F99 - F102. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Andreas, H. Reiter, L. Luthje, A. Delekat, R. W. Grunewald, G. Hasenfuss, and V. K. Somers Differential Effects of Theophylline on Sympathetic Excitation, Hemodynamics, and Breathing in Congestive Heart Failure Circulation, October 12, 2004; 110(15): 2157 - 2162. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Quintana-Gallego, M. Villa-Gil, C. Carmona-Bernal, G. Botebol-Benhamou, A. Martinez-Martinez, A. Sanchez-Armengol, J. Polo-Padillo, and F. Capote Home respiratory polygraphy for diagnosis of sleep-disordered breathing in heart failure Eur. Respir. J., September 1, 2004; 24(3): 443 - 448. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A.-M. Sinha, E. C. Skobel, O.-A. Breithardt, C. Norra, K. U. Markus, C. Breuer, P. Hanrath, and C. Stellbrink Cardiac resynchronization therapy improves central sleep apnea and Cheyne-Stokes respiration in patients with chronic heart failure J. Am. Coll. Cardiol., July 7, 2004; 44(1): 68 - 71. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Tulaimat, B. Mokhlesi, D. Stevens, M. D. Weinstein, T. D. Bradley, J. S. Floras, and K. Usui Continuous Positive Airway Pressure in Patients with Heart Failure N. Engl. J. Med., July 3, 2003; 349(1): 93 - 95. [Full Text] [PDF]
|
|