본문 바로가기
KERD
논문KCI 등재

Central Sleep Apnea in Heart Failure: Clinical Implications, Recognition, and Management

1

조회

0

다운로드

0

인용

0

참고문헌

키워드

초록

Central sleep apnea (CSA) is characterized by a lack of respiratory drive during sleep, resulting in repetitive periods of insufficient ventilation and compromised gas exchange. These nighttime breathing disturbances can lead to daytime impairment and poor cardiovascular outcomes. There are several types of CSA, including idiopathic CSA, high altitude-induced periodic breathing, obesity hypoventilation syndrome, drug-induced central apnea, and Cheyne-Stokes breathing pattern. While unstable ventilatory control during sleep is the hallmark of CSA, the pathophysiology and the prevalence of the various forms of CSA varies greatly. Among them, CSA associated with heart failure is well-studied in the respect of clinical impact and management strategy. Through this article, I will summarize the underlying pathophysiology, clinical impacts, and potential treatment of CSA occurring in subjects with heart failure.

Abstract

Central sleep apnea (CSA) is characterized by a lack of respiratory drive during sleep, resulting in repetitive periods of insufficient ventilation and compromised gas exchange. These nighttime breathing disturbances can lead to daytime impairment and poor cardiovascular outcomes. There are several types of CSA, including idiopathic CSA, high altitude-induced periodic breathing, obesity hypoventilation syndrome, drug-induced central apnea, and Cheyne-Stokes breathing pattern. While unstable ventilatory control during sleep is the hallmark of CSA, the pathophysiology and the prevalence of the various forms of CSA varies greatly. Among them, CSA associated with heart failure is well-studied in the respect of clinical impact and management strategy. Through this article, I will summarize the underlying pathophysiology, clinical impacts, and potential treatment of CSA occurring in subjects with heart failure.

참고문헌 (64)

  1. Young T, "The occurrence of sleep-disordered breathing among middle-aged adults", N Engl J Med, 328, pp.1230~1235 (1993)
  2. Kim J, "Prevalence of sleep-disordered breathing in middle-aged Korean men and women", Am J Respir Crit Care Med, 170, pp.1108~1113 (2004)
  3. Garcia-Touchard A, "Central sleep apnea: implications for congestive heart failure", Chest, 133, pp.1495~1504 (2008)
  4. Somers VK, "Sleep apnea and cardiovascular disease", Circulation, 118, pp.1080~1111 (2008)
  5. Lloyd-Jones DM, "Lifetime risk for developing congestive heart failure: the Framingham Heart Study", Circulation, 106, pp.3068~3072 (2002)
  6. Javaheri S, "Sleep apnea in 81 ambulatory male patients with stable heart failure. Types and their prevalences, consequences, and presentations", Circulation, 97, pp.2154~2159 (1998)
  7. Iber C, "The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications", American Acadmey of Sleep Medicine, ~ (2007)
  8. Staats BA, "Chest wall motion in sleep apnea", Am Rev Respir Dis, 130, pp.59~63 (1984)
  9. Boudewyns A, "Assessment of respiratory effort by means of strain gauges and esophageal pressure swings: a comparative study", Sleep, 20, pp.168~170 (1997)
  10. Badr MS, "Pharyngeal narrowing", occlusion during central sleep apnea, 1995, pp.78, 1806~1815
  11. Sankri-Tarbichi AG, "Expiratory Pharyngeal Narrowing during Central Hypocapnic Hypopnea", Am. J. Respir. Crit. Care Med, pp.200805~200741 (2008)
  12. Javaheri S, "Sleep disorders in systolic heart failure: a prospective study of 100 male patients. The final report", Int J Cardiol, 106, pp.21~28 (2006)
  13. Sin DD, "Effects of continuous positive airway pressure on cardiovascular outcomes in heart failure patients with and without Cheyne-Stokes respiration", Circulation, 102, pp.61~66 (2000)
  14. Corra U, "Sleep and exertional periodic breathing in chronic heart failure: prognostic importance and interdependence", Circulation, 113, pp.44~50 (2006)
  15. Javaheri S, "Central sleep apnea, right ventricular dysfunction, and low diastolic blood pressure are predictors of mortality in systolic heart failure", J Am Coll Cardiol, 49, pp.2028~2034 (2007)
  16. Lanfranchi PA, "Prognostic value of nocturnal Cheyne-Stokes respiration in chronic heart failure", Circulation, 99, pp.1435~1440 (1999)
  17. Hanly PJ, "Increased mortality associated with Cheyne-Stokes respiration in patients with congestive heart failure", Am J Respir Crit Care Med, 153, pp.272~276 (1996)
  18. Cheyne J, "A case of apoplexy, in which the fleshy part of the heart was converted into fat", Dublin Hospital Reports and Communications, 2, pp.216~223 (1818)
  19. Bradley TD, "Central sleep apnea", Clin Chest Med, 13, pp.493~505 (1992)
  20. Brack T, "Daytime Cheyne-Stokes respiration in ambulatory patients with severe congestive heart failure is associated with increased mortality", Chest, 132, pp.1463~1471 (2007)
  21. Gottlieb DJ, "Relation of sleepiness to respiratory disturbance index: the Sleep Heart Health Study", Am J Respir Crit Care Med, 159, pp.502~507 (1999)
  22. Shahar E, "Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study", Am J Respir Crit Care Med, 163, pp.19~25 (2001)
  23. Peppard PE, "Prospective study of the association between sleep-disordered breathing and hypertension", N Engl J Med, 342, pp.1378~1384 (2000)
  24. Marin JM, "Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure:an observational study", Lancet, 365, pp.1046~1053 (2005)
  25. Yaggi HK, "Obstructive sleep apnea as a risk factor for stroke and death", N Engl J Med, 353, pp.2034~2041 (2005)
  26. Sin DD, "Relationship of systolic BP to obstructive sleep apnea in patients with heart failure", Chest, 123, pp.1536~1543 (2003)
  27. Andreas S, "Cheyne-Stokes respiration and prognosis in congestive heart failure", Am J Cardiol, 78, pp.1260~1264 (1996)
  28. Roebuck T, "Increased long-term mortality in heart failure due to sleep apnoea is not yet proven", Eur Respir J, 23, pp.735~740 (2004)
  29. Sin DD, "Risk factors for central and obstructive sleep apnea in 450men and women with congestive heart failure", Am J Respir Crit Care Med, 160, pp.1101~1106 (1999)
  30. Bradley TD, "Continuous positive airway pressure for central sleep apnea and heart failure", N Engl J Med, 353, pp.2025~2033 (2005)
  31. Nopmaneejumruslers C, "Cheyne-Stokes respiration in stroke: relationship to hypocapnia and occult cardiac dysfunction", Am J Respir Crit Care Med, 171, pp.1048~1052 (2005)
  32. Whyte KF, "Accuracy and significance of scoring hypopneas", Sleep, 15, pp.257~260 (1992)
  33. Phillipson EA, "Control of breathing during sleep", Am Rev Respir Dis, 118, pp.909~939 (1978)
  34. Dempsey JA, "Crossing the apnoeic threshold: causes and consequences", Exp Physiol, 90, pp.13~24 (2005)
  35. Hanly P, "Pathogenesis of Cheyne-Stokes respiration in patients with congestive heart failure. Relationship to arterial PCO2", Chest, 104, pp.1079~1084 (1993)
  36. Naughton M, "Role of hyperventilation in the pathogenesis of central sleep apneas in patients with congestive heart failure", Am Rev Respir Dis, 148, pp.330~338 (1993)
  37. Yu J, "Stimulation of breathing by activation of pulmonary peripheral afferents in rabbits", J Appl Physiol, 85, pp.1485~1492 (1998)
  38. Solin P, "Influence of pulmonary capillary wedge pressure on central apnea in heart failure", Circulation, 99, pp.1574~1579 (1999)
  39. Lorenzi-Filho G, "Relationship of carbon dioxide tension in arterial blood to pulmonary wedge pressure in heart failure", Eur Respir J, 19, pp.37~40 (2002)
  40. Paintal AS, "Vagal sensory receptors and their reflex effects", Physiol Rev, 53, pp.159~227 (1973)
  41. Javaheri S, "A mechanism of central sleep apnea in patients with heart failure", N Engl J Med, 341, pp.949~954 (1999)
  42. Solin P, "Peripheral and central ventilatory responses in central sleep apnea with and without congestive heart failure", Am J Respir Crit Care Med, 162, pp.2194~2200 (2000)
  43. Xie A, "Apneahypopnea threshold for CO2 in patients with congestive heart failure", Am J Respir Crit Care Med, 165, pp.1245~1250 (2002)
  44. Crowell JW, "Basic oscillating mechanism of Cheyne-Stokes breathing", Am J Physiol, 187, pp.395~398 (1956)
  45. Hall MJ, "Cycle length of periodic breathing in patients with and without heart failure", Am J Respir Crit Care Med, 154, pp.376~381 (1996)
  46. Datta AK, "The influence of induced hypocapnia and sleep on the endogenous respiratory rhythm in humans", J Physiol, 440, pp.17~33 (1991)
  47. Ferrier K, "Sleep-disordered breathing occurs frequently in stable outpatients with congestive heart failure", Chest, 128, pp.2116~2122 (2005)
  48. Wang H, "Influence of obstructive sleep apnea on mortality in patients with heart failure", J Am Coll Cardiol, 49, pp.1625~1631 (2007)
  49. Dark DS, "Breathing pattern abnormalities and arterial oxygen desaturation during sleep in the congestive heart failure syndrome. Improvement following medical therapy", Chest, 91, pp.833~836 (1987)
  50. Mansfield DR, "The effect of successful heart transplant treatment of heart failure on central sleep apnea", Chest, 124, pp.1675~1681 (2003)
  51. Walsh JT, "Effects of captopril and oxygen on sleep apnoea in patients with mild to moderate congestive cardiac failure", Br Heart J, 73, pp.237~241 (1995)
  52. Tkacova R, "Left ventricular volume in patients with heart failure and Cheyne-Stokes respiration during sleep", Am J Respir Crit Care Med, 156, pp.1549~1555 (1997)
  53. Lanfranchi PA, "Central sleep apnea in left ventricular dysfunction:prevalence and implications for arrhythmic risk", Circulation, 107, pp.727~732 (2003)
  54. Series F, "Prospective evaluation of nocturnal oximetry for detection of sleep-related breathing disturbances in patients with chronic heart failure", Chest, 127, pp.1507~1514 (2005)
  55. Naughton MT, "Effects of nasal CPAP on sympathetic activity in patients with heart failure and central sleep apnea", Am J Respir Crit Care Med, 152, pp.473~479 (1995)
  56. Naughton MT, "Treatment of congestive heart failure and Cheyne-Stokes respiration during sleep by continuous positive airway pressure", Am J Respir Crit Care Med, 151, pp.92~97 (1995)
  57. Naughton MT, "Effect of continuous positive airway pressure on intrathoracic and left ventricular transmural pressures in patients with congestive heart failure", Circulation, 91, pp.1725~1731 (1995)
  58. Mehta S, "Effects of continuous positive airway pressure on cardiac volumes in patients with ischemic and dilated cardiomyopathy", Am J Respir Crit Care Med, 161, pp.128~134 (2000)
  59. Javaheri S, "Effects of continuous positive airway pressure on sleep apnea and ventricular irritability in patients with heart failure", Circulation, 101, pp.392~397 (2000)
  60. Arzt M, "Suppression of central sleep apnea by continuous positive airway pressure and transplant-free survival in heart failure: a post hoc analysis of the Canadian Continuous Positive Airway Pressure for Patients with Central Sleep Apnea and Heart Failure Trial (CANPAP)", Circulation, 115, pp.3173~3180 (2007)
  61. Teschler H, "Adaptive pressure support servo-ventilation: a novel treatment for Cheyne-Stokes respiration in heart failure", Am J Respir Crit Care Med, 164, pp.614~619 (2001)
  62. Pepperell JC, "A randomized controlled trial of adaptive ventilation for Cheyne-Stokes breathing in heart failure", Am J Respir Crit Care Med, 168, pp.1109~1114 (2003)
  63. Philippe C, "Compliance with and effectiveness of adaptive servoventilation versus continuous positive airway pressure in the treatment of Cheyne-Stokes respiration in heart failure over a six month period", Heart, 92, pp.337~342 (2006)
  64. Arzt M, "Effects of dynamic bilevel positive airway pressure support on central sleep apnea in men with heart failure", Chest, 134, pp.61~66 (2008)

관련 논문AI추천

이 간행물의 다른 논문 (7건)