Cheyne-Stokes respiration (CSR) is common in patients with advanced heart failure and its impact on circulatory function is unclear. To explore the effects of CSR on autonomie reflex control, we determined arterial pressure (AP, Finapres, n=9) and muscle sympathetic nerve activity (MSNA, peroneal microneurography; n=6) during phases of CSR in hospitalized patients with heart failure (age 54±4 yrs, left-ventricular ejection fraction 22±7%). During apnea (duration 27±2 sec, minimum O2 saturation 89±1%), mean AP decreased from 91±5 to 86±4 mmHg and rose to 97±5 mmHg during the hyperventilatory phase of the breathing cycle (p<0.05 for both compared to baseline). In contrast, MSNA rose from 427±112 to 591±166 units during apnea and decreased to 336±119 units during hyperventilation (p<0.05 for both compared to baseline). Similar changes were noted when MSNA was expressed as burst frequency. The changes of pulmonary artery, pulmonary capillary wedge and central venous pressure during the breathing cycle paralleled the changes in AP (n=3). Thus, CSR is accompanied by fluctuations of AP which appear to be linked to periodic surges of MSNA. Furthermore, the inverse relationship between AP and MSNA is consistent with modulation of MSNA by input from arterial and/or cardiopulmonary baroreceptors. We speculate that repetitive surges of sympathetic nerve activity, transient increases of left-ventricular preload and afterload and periods of hypoxia associated with CSR may have adverse effects on cardiocirculatory function.
|Original language||English (US)|
|State||Published - Dec 1 1997|
All Science Journal Classification (ASJC) codes
- Molecular Biology