title: Evaluation of upper airway patency during Cheyne-Stokes breathing in heart failure patients.
abstract: Little is known about the changes in upper airway calibre in Cheyne-Stokes respiration (CSR) during sleep in patients with congestive heart failure. This study aimed to test the hypothesis that upper airway closure occurs during central CSR events, by assessing upper airway calibre during sleep using the forced oscillation technique (FOT). Nine males with compensated heart failure (left ventricular ejection fraction mean ± sem 27.9 ± 5.1%) and predominant central CSR (apnoea/hypopnoea index 43.9 ± 4.2 events · h(-1)) were studied during overnight polysomnography, which included pneumotachography, inductance plethysmography or oesophageal pressure and FOT-derived impedance signal (|Z|). Baseline |Z| values during stable breathing in stage 2 sleep were 11.0 ± 1.3 cmH(2)O · s · L(-1). Mean |Z| increased to 31.9 ± 6.7 cmH(2)O · s · L(-1) during obstructive apnoeas (7% of events, n = 46). Increases in |Z| consistent with upper airway narrowing (more than two-fold baseline) were common during central apnoeas (50 ± 12% of events) occurring in the middle or end of apnoeas and occurred during some central hypopnoeas (16 ± 10% of events), typically in the expiratory phase. These findings indicate that in heart failure patients, reductions in upper airway calibre are common during CSR apnoeas, and may also occur during central hypopnoeas.
authors.affiliation: Respiratory Division, Meakins-Christie Laboratories, McGill University, Montreal, QC, Canada.
authors.forename: Vincent
authors.initials: V
authors.lastname: Jobin
authors.forename: Jordi
authors.initials: J
authors.lastname: Rigau
authors.forename: Josée
authors.initials: J
authors.lastname: Beauregard
authors.forename: Ramon
authors.initials: R
authors.lastname: Farre
authors.forename: Josep
authors.initials: J
authors.lastname: Monserrat
authors.forename: T Douglas
authors.initials: TD
authors.lastname: Bradley
authors.forename: R John
authors.initials: RJ
authors.lastname: Kimoff
mesh_terms: D000328:Adult; D000368:Aged; D002639:Cheyne-Stokes Respiration / Q000503:physiopathology*; D045422:Continuous Positive Airway Pressure; D006333:Heart Failure / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009991:Oscillometry / Q000379:methods; D017286:Polysomnography; D012119:Respiration; D012890:Sleep