[Cheyne-Stokes respiration and cardiovascular risk].
Due to its high prevalence in patients with heart failure and its negative predictive value concerning morbidity and mortality, Cheyne-Stokes respiration (CSR) is a sleep disorders of major interest. CSR correlates with the degree of heart failure and is characterised by a typical crescendo/decrescendo breathing pattern combined with phases of central sleep apnoea, caused by pulmonary oedema and oscillation of ventilatory control. Thus, CSR is a marker of the severity of heart failure. Treatment of CSR first involves optimisation of heart failure therapy by cardiologists and then application of non-invasive means of ventilatory support. Treatment of patients with severe heart failure with non-invasive positive pressure ventilatory support leads to a significant reduction of CSR, sympathetic activity, and daytime sleepiness and improves cardiac output and 6-minute walking distance. At present, a prospective randomised, controlled intervention-study (Serve-HF study) is being conducted in order to show if therapy of CSR can improve patient survival. This review describes the pathophysiology, epidemiology, and therapeutic options of CSR with a special focus on the elevated cardiovascular risk of patients with CSR.
Duchna
H-W
HW
Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil GmbH, Medizinische Klinik III, Pneumologie, Allergologie, Schlaf- und Beatmungsmedizin, Bochum. hans-werner.duchna@rub.de
Schultze-Werninghaus
G
G
D002639:Cheyne-Stokes Respiration / Q000401:mortality* / Q000517:prevention & control*; D015897:Comorbidity; D006333:Heart Failure / Q000401:mortality* / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D018570:Risk Assessment