PMID: 9525293Apr 3, 1998Paper

Central sleep apnoea and heart failure (Part I)

Respirology : Official Journal of the Asian Pacific Society of Respirology
K R Burgess

Abstract

Central sleep apnoea (CSA) in congestive heart failure is sleep state dependent and occurs typically in stages I and II of non-REM sleep. The pre-requisites are hypocapnia and some prolongation of the circulation time. It is not certain whether abnormalities in after-discharge activity in the brainstem are also important. The presence of CSA in patients with left ventricular dysfunction is a poor prognostic sign and associated with a higher mortality in that group compared to age, sex and ejection fraction matched patients with congestive cardiac failure alone. It is reasonable to speculate that the CSA causes an increase in sympathetic nervous system activity which would maintain afterload at a high level or tend to increase it with time. The application of a high afterload to an impaired left ventricle leads over time to a further reduction in ejection fraction. From other studies, particularly ACE inhibitor studies, it is known that ejection fraction and prognosis are almost linearly related. It could therefore be said that once CSA has developed it may lead to a vicious circle of increasing afterload and further reduction in ejection fraction, causing worsening CSA and further increases in afterload. A number of treatments ...Continue Reading

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Citations

Jun 9, 2004·Respirology : Official Journal of the Asian Pacific Society of Respirology·Keith R BurgessNatalie Edwards
Dec 5, 2000·British Journal of Anaesthesia·J A Loadsman, I Wilcox
Mar 31, 2015·The Journal of Physiology·Peter G R BurkePatrice G Guyenet
Feb 24, 2009·The American Journal of Cardiology·Noriaki Takama, Masahiko Kurabayashi
Sep 6, 2005·Respiratory Physiology & Neurobiology·Evelyn SchlenkerJoni Wipf
Oct 30, 2014·Pacing and Clinical Electrophysiology : PACE·Musa CakiciErdal Akturk
Jul 29, 2009·Journal of the International Neuropsychological Society : JINS·Teresa TorralvaFacundo Manes
Aug 4, 2007·Journal of Applied Physiology·Motoo YamauchiKingman P Strohl
Jun 26, 2021·Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine·Atul MalhotraUNKNOWN medXcloud group

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