title: Predictors of oxidative stress in heart failure patients with Cheyne-Stokes respiration.
abstract: OBJECTIVE
  Cheyne-Stokes respiration during sleep is associated with increased mortality in heart failure. The magnitude of oxidative stress is a marker of disease severity and a valuable predictor of mortality in heart failure. Increased oxidative stress associated with periodic breathing during Cheyne-Stokes respiration may mediate increased mortality in these patients. We hypothesized that the presence of Cheyne-Stokes respiration is associated with oxidative stress by increasing the formation of reactive oxygen species in patients with heart failure.
  
  
  RESULTS
  Twenty-three patients with heart failure [left ventricular ejection fraction 30.2 ± 9% (mean ± standard deviation)] and 11 healthy controls underwent nocturnal polysomnography. Subjects with obstructive sleep apnea were excluded. The majority (88%) of patients with heart failure had Cheyne-Stokes respiration during sleep. The intensity of oxidative stress in neutrophils was greater in patients with heart failure (4,218 ± 1,706 mean fluorescence intensity/cell vs. 1,003 ± 348 for controls, p < 0.001) and correlated with the duration of Cheyne-Stokes respiration. Oxidative stress was negatively correlated with SaO(2) nadir during sleep (r = -0.43, p = 0.039). The duration of Cheyne-Stokes respiration predicted severity of oxidative stress in patients with heart failure (beta = 483 mean fluorescence intensity/cell, p < 0.02).
  
  
  CONCLUSIONS
  Levels of oxidative stress are increased in patients with heart failure and Cheyne-Stokes respiration during sleep compared with healthy controls. The duration of Cheyne-Stokes respiration predicts the magnitude of oxidative stress in heart failure. Increased oxidative stress may mediate increased mortality associated with Cheyne-Stokes respiration in patients with heart failure.
authors.affiliation: Weill Cornell Medical College of Cornell University, New York, NY 10065, USA. ack2003@med.cornell.edu
authors.forename: Ana C
authors.initials: AC
authors.lastname: Krieger
authors.forename: Daniel
authors.initials: D
authors.lastname: Green
authors.forename: Muriel T
authors.initials: MT
authors.lastname: Cruz
authors.forename: Frank
authors.initials: F
authors.lastname: Modersitzki
authors.forename: Gita
authors.initials: G
authors.lastname: Yitta
authors.forename: Sanja
authors.initials: S
authors.lastname: Jelic
authors.forename: Doris S
authors.initials: DS
authors.lastname: Tse
authors.forename: Steven P
authors.initials: SP
authors.lastname: Sedlis
mesh_terms: D000368:Aged; D002639:Cheyne-Stokes Respiration / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000502:physiology*; D017286:Polysomnography; D011379:Prognosis; D017382:Reactive Oxygen Species / Q000378:metabolism; D012016:Reference Values; D012307:Risk Factors
chemical_list: D017382:Reactive Oxygen Species