Long-term assessment of nocturnal Cheyne-Stokes respiration in patients with heart failure.
OBJECTIVE
Cheyne-Stokes respiration (CSR) is a known controversial prognostic marker in patients with heart failure (HF). Little is known, moreover, about the development and progress of CSR in such patients. The CSR progress over time may be indicative for clinical deterioration in patients with HF disease


METHODS
Prospective cohort sleep studies, with algorithm-based analyses of continuously or periodically monitored changes over time using standard pulse oximeter. Home testing for 4 months of patients recruited from the cardiology department of a large community medical center in Haifa, Israel. A total of 36 patients, 31 men and five women, aged between 50 and 74 years, with symptomatic chronic HF.


RESULTS
Out of the 36 patients, 15 (42%) patients were found to have CSR. The CSR cycle length was chosen as the characteristic parameter which determines the periodicity of the event and its length. Analyses of CSR cycle length and duration in the 15 patients showed changes over time in the length of the CSR event only in patient with New York Heart Association (NYHA) 4 classification.


CONCLUSIONS
Nocturnal CSR in patients with HF show small variations over time in the prevalence or duration of the cycle length and could be a marker for entering stage 4 or deterioration in the NYHA class of HF patient. Moreover, it may take years for HF patients to develop CSR or to increase the length of the cycle length of existing CSR, if they develop it at all.
Heart Failure Center Division of Cardiology, Lady Davis Carmel Medical Center, Haifa, Israel. offeram@012.net.il
Offer
O
Amir
Deganit
D
Barak-Shinar
Rafael
R
Wolff
Hagar
H
Paz
Guy
G
Dori
Frank W
FW
Smart
Basil S
BS
Lewis
D000368:Aged; D000465:Algorithms; D002639:Cheyne-Stokes Respiration / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography / Q000379:methods*; D011379:Prognosis