Source: International Congress 2014 – The story continues: impact of OSA on cardiometabolic parameters
Disease area: Pulmonary vascular diseases

Abstract

Cheyne-Stokes respiration (CSR) in heart failure (HF) patients is characterized by hyperventilation (HV) with low arterial partial pressure of CO₂ (pCO₂). It is still questioned whether this HL characterizes a compensatory response to HF or represents an independent comorbidity. Aim of the present study was to investigate the hemodynamic effects of HL.Hemodynamic effects of voluntary HV were investigated in 15 healthy volunteers (HVOL; 13 male, 25±4 years, BNP<49pg/ml, NYHA O, LVEF > 55%) and 19 HF patients (14male, 67±12years, NYHA class 2.6±0.6, BNP 802±839pg/ml, LV-EF 33.5 ±9.0%). Non-invasive hemodynamic monitoring was used in HVOL whereas invasive measurements were used in HF patients. Transcutaneous (tc) pCO₂ was used in HVOL and aortal blood gas analysis was used in HF patients to verify and quantify HV.During HV PtcCO₂ in HVOL dropped from 38.74±2.5 to 28.6±3.3 mmHg (p<0.001) and pCO₂ in HF patients from 33.0 ± 3.6 to 22.3 ± 3.3mmHg (p<0.001). There was a significant increase in cardiac output (CO) in HVOL and HF, mainly based on an increase in heart rate (HR).

	Healthy Volunteers			Heart Failure Patients
CO, l/min	6.2±1.3	7.5±1.3	p<0.001	4.3±1.3	5.0±1.4	p=0.004
SV, ml	93.7±19.6	93.8±21.4	n.s.	60.8±28.0	67.4±23.4	n.s.
HR, bpm	67.4±7.6	82.8±10.9	p<0.001	77.8±18.0	86.1±22.8	p=0001

HV leads to an increase in cardiac output in healthy volunteers as well as in heart failure patients. This increase is mainly due to an increase in heart rate. Cheyne-Stokes respiration with associated hyperventilation might be a compensatory mechanism in patients with a failing heart, but because this is due to an increase in heart rate, it might be deleterious in the long run.

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Citations should be made in the following way:
O. Oldenburg, H. Fox, J. Spießhöfer, T. Bitter, D. Horstkotte (Bad Oeynhausen, Germany). Hemodynamic effects of Cheyne-Stokes respiration in heart failure?. Eur Respir J 2014; 44: Suppl. 58, 1753

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