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Editorials |

Cheyne-Stokes Respiration: A Consequence of a Broken Heart?

Don D. Sin; Godfrey C. W. Man
Author and Funding Information

Affiliations: Edmonton, AB, Canada
 ,  Dr. Sin is Assistant Professor of Medicine and Dr. Man is Professor of Medicine, University of Alberta.

Correspondence to: Don D. Sin, MD, FCCP, 2E4.29 Walter C. Mackenzie Centre, University of Alberta, Edmonton, AB, Canada T6G 2B7; e-mail: don.sin@ualberta.ca



Chest. 2003;124(5):1627-1628. doi:10.1378/chest.124.5.1627
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Cheyne-Stokes respiration (CSR) with central sleep apnea (CSA) [CSR-CSA] is a breathing disorder seen in patients with advanced congestive heart failure (CHF) that is characterized by the presence of central apneas and hypopneas, alternating with periods of crescendo-decrescendo tidal volume.1 CSR-CSA has been associated, in a severity-dependent manner, with elevations of sympathetic nervous activity in CHF patients,2 which is an important predictor of CHF progression, arrhythmias, and mortality.34 Indeed, CSR-CSA, independent of other risk factors, elevates the risk of mortality in CHF by twofold to threefold.5 Successful treatment of CSR by continuous positive airway pressure (CPAP) leads to a significant reduction in sympathetic nervous activity2 and may reduce mortality rates by up to 40% in patients with CHF and CSR-CSA.6 Since CPAP has salutary effects on cardiac function (independent of its effect on CSR), it remains uncertain whether CSR-CSA is a mere epiphenomenon of a failing heart or a major contributor of poor outcomes of patients with CHF.

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