The incidence, pathophysiology, treatment and prognosis of Cheyne-Stokes breathing disorder in patients with congestive heart failure.
BACKGROUND
Cheyne-Stokes respiration is a breathing disorder characterized by recurrent central sleep apneas, mainly during sleep, alternating with a crescendo-decrescendo pattern of tidal volume. PATHOPHYSIOLOGY AND PROGNOSIS: The pathophysiology of Cheyne-Stokes respiration, involving the cardiovascular, pulmonary and sympathetic nervous systems, is still not well understood. Although 50% of moderate to severe congestive heart failure patients suffer from significant Cheyne-Stokes respiration, studies been undertaken to determine the prevalence of this phenomenon and its implications regarding patients' life expectancy and quality of life were conducted only in recent years. Other studies suggest that Cheyne-Stokes respiration has a negative prognostic value upon congestive heart failure patients.


METHODS
Novel therapeutic approaches have been attempted in order to treat Cheyne-Stokes respiration; they include oxygen delivery, various pharmaceutical treatments aimed to stabilize the ventilatory system and other pharmaceutical treatments aimed to improve the left ventricular ejection fraction. However, none of them was effective.


OBJECTIVE
This review summarizes some of the current knowledge regarding Cheyne-Stokes respiration pathophysiology, prevalence, prognostic implication and available treatments.
Ingbir
Merav
M
Cardiac Rehabilitation Institute and Heart Failure Unit, Sheba Medical Center, Tel Hashomer, Israel.
Freimark
Dov
D
Motro
Michael
M
Adler
Yehuda
Y
D002316:Cardiotonic Agents / Q000627:therapeutic use; D002639:Cheyne-Stokes Respiration / Q000503:physiopathology* / Q000628:therapy; D006333:Heart Failure / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D015994:Incidence; D011379:Prognosis; D012121:Respiration, Artificial; D020182:Sleep Apnea, Central / Q000503:physiopathology / Q000628:therapy; D013318:Stroke Volume / Q000502:physiology
D002316:Cardiotonic Agents