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Breathing Pattern Can Predict Mortality in Heart Failure Patients
By Dr. James Chappell of www.jameschappell.com
A particular breathing pattern known to be associated with a poor prognosis occurs frequently during sleep in patients with severe heart failure. It is called “Cheyne-Stokes Respiration” (CSR) and it is characterized by a gradual increase in the amount of air that is breathed in each breath for fifteen or twenty breaths, followed by a corresponding gradual decrease for a similar number of breaths, then followed by a period when breathing is suspended. These three parts constitute the CSR pattern, which can be repeated for a period of time. Until recently, virtually all of the data that has been collected about CSR has been done at night from subjects undergoing sleep studies in specialized sleep labs. The relationship between nighttime CRS and poor outcomes for cardiac patients has been well established. It is not a good sign but nighttime CSR has not proven to be predictive of mortality. However, a recent Swiss study of patients with severe congestive heart failure looked at CSR in the daytime as well as during sleep, and found that the presence of daytime CSR - sometimes referred to as periodic breathing - was, in fact, predictive of mortality. What this means is that the assessment of prognosis of severe heart failure patients should not be confined to sleep studies. Daytime data are much more revealing and can identify patients who have a high prospect of dying within 6 months and who, therefore, are candidates for more intensive forms of care. This, naturally, is of considerable significance for anyone with severe heart failure. The study was published in the journal CHEST in July 2007.
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May, 2012
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