Current and future developments in the field of central sleep apnoea.
Europace
; 18(8): 1123-34, 2016 Aug.
Article
in En
| MEDLINE
| ID: mdl-27234869
ABSTRACT
Central sleep apnoea (CSA) occurs in â¼30-50% of patients with heart failure (HF) with reduced left ventricular ejection fraction (LVEF) and in as much as in 18-30% of patients with preserved LVEF. In HF patients, it is characterized by periodic breathing also known as the Cheyne-Stokes respiration followed by pauses of breathing. Central sleep apnoea remains often unrecognized due to its chronic and insidious incidences. Patients may report excessive daytime somnolence, poor sleep quality, nocturnal angina, recurrent arrhythmias, refractory HF symptoms, or demonstrate abnormal respiratory pattern or apnoeas. The pathogenesis of CSA remains incompletely understood, but changes in CO2 above and below the apnoea threshold play a major role in its pathogenesis. The presence of CSA in patients with HF is associated with some neurohumoral and haemodynamic responses that are detrimental to the failing heart including increased morbidity and mortality. The development of successful therapies targeting CSA and its harmful downstream effects is therefore important. Several different therapies from medications to implantable devices have been tested with varying effects and primarily in small non-randomized and/or single-centre studies. Large studies to date have been disappointing, but therapeutic options targeting the physiology of the disease may herald a new era in understanding and treating CSA.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Cheyne-Stokes Respiration
/
Sleep Apnea, Central
/
Heart Failure
Type of study:
Clinical_trials
Limits:
Humans
Language:
En
Journal:
Europace
Journal subject:
CARDIOLOGIA
/
FISIOLOGIA
Year:
2016
Type:
Article
Affiliation country:
Germany