In patients with heart failure, enhanced ventilatory response to exercise is associated with severe obstructive sleep apnea | Zendy

Lia Bittencourt | Zendy; Shahrokh Javaheri | Zendy; Denise Maria Servantes | Zendy; Ana Claudia Pelissari Kravchychyn | Zendy; Dirceu Rodrigues Almeida | Zendy; Sérgio Tufik | Zendy

Open Access

In patients with heart failure, enhanced ventilatory response to exercise is associated with severe obstructive sleep apnea

Author(s) -

Lia Bittencourt,

Shahrokh Javaheri,

Denise Maria Servantes,

Ana Claudia Pelissari Kravchychyn,

Dirceu Rodrigues Almeida,

Sérgio Tufik

Publication year - 2021

Publication title -

journal of clinical sleep medicine

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 1.529

H-Index - 92

eISSN - 1550-9397

pISSN - 1550-9389

DOI - 10.5664/jcsm.9396

Subject(s) - medicine , central sleep apnea , polysomnography , cardiology , heart failure , obstructive sleep apnea , ejection fraction , respiratory minute volume , ventilation (architecture) , sleep apnea , apnea–hypopnea index , body mass index , apnea , anesthesia , respiratory system , mechanical engineering , engineering

Patients with congestive heart failure (CHF) frequently exhibit an elevated ratio of minute ventilation over CO 2 output (VE/VCO 2 slope) while undergoing exercise tests. One of the factors contributing to this elevated slope is an increased chemosensitivity to CO 2 in that this slope significantly correlates with the slope of the ventilatory response to CO 2 rebreathing at rest. A previous study in patients with CHF and central sleep apnea showed that the highest VE/VCO 2 slope during exercise was associated with the most severe central sleep apnea. In the current study, we tested the hypothesis that in patients with CHF and obstructive sleep apnea (OSA), the highest VE/VCO 2 slope is also associated with the most severe OSA. If the hypothesis is correct, then it implies that in CHF, augmented instability in the negative feedback system controlling breathing predisposes to both OSA and central sleep apnea.

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