Cardiovascular autonomic control and baroreceptor sensitivity in patients with stable chronic heart failure and sleep disordered breathing
S. Asadi, M. Ruis, S. Radakovic, I. Mikulic, O. Burghuber, A. Valipour (Vienna, Austria)
Source: Annual Congress 2010 - Nocturnal cardiology: chronic heart failure, acute chest syndrome, coronary artery disease and collagen vascular disease
Disease area: Sleep and breathing disorders
Abstract Objectives: We hypothesized differences in cardiovascular autonomic control and baroreceptor function between patients with stable chronic heart failure and Cheyne-Stokes-Respiration (CHF-CSR) and heart failure patients with obstructive sleep apnea (CHF-OSA). Methods: We studied 14 patients with polysomnographically diagnosed CHF-CSR and 14 age, body-mass-index, and apnea-hypopnea index (AHI) matched patients with CHF-OSA.Cardiovascular autonomic tone was recorded using power spectral analysis of R-R interval variability on the morning after polysomnography.The slope of the regression line between beat-to-beat spontaneous systolic blood pressure and pulse interval changes was taken as an index of the sensitivity of arterial baroreflex modulation. Results: The two groups did not differ with respect to left ventricular ejection fraction, pharmacologic treatment, or etiology of heart failure. Mean AHI was 33±14/hr in patients with CHF-CSR and 25±15/hr in patients with CHF-OSA (p>0.05).Patients with CHF-CSR had significantly higher sympathetically mediated low frequency R-R interval variability (58±16 vs 29±15% normalized units, p<0.01) and higher low-to-high frequency ratio of R-R interval variability (2.0±1.8 vs. 0.5±0.4, p<0.01) than patients with CHF-OSA.Consistent with these findings, mean slope of spontaneous baroreceptor activity was significantly lower in patients with CHF-CSR than in CHF-OSA (8.3±3.3 vs 35.6±24.5, p=0.01). Conclusions: We observed significant differences in both sympathetic activity and baroreceptor sensitivity between patients with CHF-CSR and CHF-OSA despite similar cardiac function impairment and sleep parameters.
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S. Asadi, M. Ruis, S. Radakovic, I. Mikulic, O. Burghuber, A. Valipour (Vienna, Austria). Cardiovascular autonomic control and baroreceptor sensitivity in patients with stable chronic heart failure and sleep disordered breathing. Eur Respir J 2010; 36: Suppl. 54, 902
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