Cheyne-Stokes respiration in patients hospitalised for heart failure.
BACKGROUND
Previous studies showing a strong relationship between Cheyne-Stokes respiration and the severity of left ventricular systolic dysfunction have usually been done in selected patient populations with lower age and a higher proportion of males than the "typical" in-hospital patient with heart failure. The purpose of the present study was test the strength of this relationship in unselected patients admitted to hospital due to decompensated chronic heart failure.


METHODS
We evaluated 191 patients (32% women), mean age 73 years, ready for discharge from the heart failure unit in the University Hospital of Malmo, Sweden. The patients underwent echocardiography for determination of left ventricular ejection fraction and left ventricular inner diastolic diameter. A respiratory investigation during sleep was performed the last night before discharge.


RESULTS
We found that 66% of the patients had Cheyne-Stokes respiration more than 10% of the total recording time. Only 7 (3.6%) of the patients had predominantly obstructive apnoeas. There was a significant but very weak relationship between left ventricular ejection fraction and left ventricular inner diastolic diameter on one hand and Cheyne-Stokes respiration on the other. Age was a stronger determinant of Cheyne-Stokes respiration than any of the cardiac or other clinical variables.


CONCLUSIONS
Although presence of Cheyne-Stokes respiration indicates left ventricular dysfunction, its severity seems only weakly related to the severity of heart failure. Age was found to be a stronger determinant, which may reflect the underlying age-dependency found also in healthy subjects. Due to age restrictions or other selection criteria, the importance of age may have been underestimated in many previous studies on factors associated with Cheyne-Stokes respiration.
Mared
Lena
L
Dept of Respiratory Medicine, University Hospital, Lund, Sweden. lena.mared@lung.lu.se <lena.mared@lung.lu.se>
Cline
Charles
C
Erhardt
Leif
L
Berg
Søren
S
Midgren
Bengt
B
D017677:Age Distribution; D000368:Aged; D002639:Cheyne-Stokes Respiration / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D017678:Sex Distribution; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000453:epidemiology*