Skip to main content
Top
Published in: Current Heart Failure Reports 1/2011

01-03-2011

Recognition and Management of Sleep-Disordered Breathing in Chronic Heart Failure

Authors: Rami Kahwash, Donald Kikta, Rami Khayat

Published in: Current Heart Failure Reports | Issue 1/2011

Login to get access

Abstract

It is increasingly recognized that sleep-disordered breathing (SDB) is a common modifiable risk factor for cardiovascular disease with significant impact on morbidity and potentially mortality. SDB is highly prevalent in patients with systolic or diastolic heart failure. A high index of suspicion is necessary to diagnose SDB in patients with heart failure because the vast majority of affected patients do not report daytime symptoms. Recent clinical trials have demonstrated improvement in heart function, exercise tolerance, and quality of life after treatment of SDB in patients with heart failure. Accumulating evidence suggests that treatment of SDB should complement the established pharmacologic therapy for chronic heart failure. However, mortality benefit has yet to be demonstrated.
Literature
1.
go back to reference Mansfield DR, Gollogly NC, Kaye DM, Richardson M, Bergin P, Naughton MT: Controlled trial of continuous positive airway pressure in obstructive sleep apnea and heart failure. Am J Respir Crit Care Med 2004, 169(3):361-366.PubMedCrossRef Mansfield DR, Gollogly NC, Kaye DM, Richardson M, Bergin P, Naughton MT: Controlled trial of continuous positive airway pressure in obstructive sleep apnea and heart failure. Am J Respir Crit Care Med 2004, 169(3):361-366.PubMedCrossRef
2.
go back to reference •• Javaheri S, Caref EB, Chen E, Tong KB, Abraham WT: Sleep Apnea Testing and Outcomes in a Large Cohort of Medicare Beneficiaries with Newly Diagnosed Heart Failure. Am J Respir Crit Care Med 2010. One of the largest retrospective reviews, the authors demonstrated a staggering degree of underdiagnosis of SDB in patients with heart failure. Also, this study demonstrated an association between SDB and negative outcome in patients with heart failure. •• Javaheri S, Caref EB, Chen E, Tong KB, Abraham WT: Sleep Apnea Testing and Outcomes in a Large Cohort of Medicare Beneficiaries with Newly Diagnosed Heart Failure. Am J Respir Crit Care Med 2010. One of the largest retrospective reviews, the authors demonstrated a staggering degree of underdiagnosis of SDB in patients with heart failure. Also, this study demonstrated an association between SDB and negative outcome in patients with heart failure.
3.
go back to reference Teschler H, Dohring J, Wang YM, Berthon-Jones M: Adaptive pressure support servo-ventilation: a novel treatment for Cheyne-Stokes respiration in heart failure. Am J Respir Crit Care Med 2001, 164(4):614–619.PubMed Teschler H, Dohring J, Wang YM, Berthon-Jones M: Adaptive pressure support servo-ventilation: a novel treatment for Cheyne-Stokes respiration in heart failure. Am J Respir Crit Care Med 2001, 164(4):614–619.PubMed
4.
go back to reference Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S: The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993, 328(17):1230–1235.PubMedCrossRef Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S: The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993, 328(17):1230–1235.PubMedCrossRef
5.
go back to reference Javaheri S, Parker TJ, Liming JD, Corbett WS, Nishiyama H, Wexler L, Roselle GA: Sleep apnea in 81 ambulatory male patients with stable heart failure. Types and their prevalences, consequences, and presentations. Circulation 1998, 97(21):2154–2159.PubMed Javaheri S, Parker TJ, Liming JD, Corbett WS, Nishiyama H, Wexler L, Roselle GA: Sleep apnea in 81 ambulatory male patients with stable heart failure. Types and their prevalences, consequences, and presentations. Circulation 1998, 97(21):2154–2159.PubMed
6.
go back to reference •• Khayat R, Jarjoura D, Patt B, Yamokoski T, and Abraham, WT: In-hospital Testing for Sleep-disordered Breathing in Hospitalized Patients With Decompensated Heart Failure: Report of Prevalence and Patient Characteristics. Journal of Cardiac Failure 2009. This was one of the largest studies to demonstrate the higher prevalence of OSA than CSA in patients with heart failure. The implications of this study were to focus attention on the highly treatable type of SDB in patients with heart failure. •• Khayat R, Jarjoura D, Patt B, Yamokoski T, and Abraham, WT: In-hospital Testing for Sleep-disordered Breathing in Hospitalized Patients With Decompensated Heart Failure: Report of Prevalence and Patient Characteristics. Journal of Cardiac Failure 2009. This was one of the largest studies to demonstrate the higher prevalence of OSA than CSA in patients with heart failure. The implications of this study were to focus attention on the highly treatable type of SDB in patients with heart failure.
7.
go back to reference Young T, Peppard P, Palta M, Hla KM, Finn L, Morgan B, Skatrud J: Population-based study of sleep-disordered breathing as a risk factor for hypertension. Arch Intern Med 1997, 157(15):1746–1752.PubMedCrossRef Young T, Peppard P, Palta M, Hla KM, Finn L, Morgan B, Skatrud J: Population-based study of sleep-disordered breathing as a risk factor for hypertension. Arch Intern Med 1997, 157(15):1746–1752.PubMedCrossRef
8.
go back to reference Peppard PE, Young T, Palta M, Skatrud J: Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 2000, 342(19):1378–1384.PubMedCrossRef Peppard PE, Young T, Palta M, Skatrud J: Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 2000, 342(19):1378–1384.PubMedCrossRef
9.
go back to reference Peker Y, Hedner J, Kraiczi H, Loth S: Respiratory disturbance index: an independent predictor of mortality in coronary artery disease. Am J Respir Crit Care Med 2000, 162(1):81–86.PubMed Peker Y, Hedner J, Kraiczi H, Loth S: Respiratory disturbance index: an independent predictor of mortality in coronary artery disease. Am J Respir Crit Care Med 2000, 162(1):81–86.PubMed
10.
go back to reference Marin JM, Carrizo SJ, Vicente E, Agusti AG: Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 2005, 365(9464):1046–1053.PubMed Marin JM, Carrizo SJ, Vicente E, Agusti AG: Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 2005, 365(9464):1046–1053.PubMed
11.
go back to reference •• Gottlieb DJ, Yenokyan G, Newman AB, O'Connor GT, Punjabi NM, Quan SF, Redline S, Resnick HE, Tong EK, Diener-West M et al: Prospective study of obstructive sleep apnea and incident coronary heart disease and heart failure: the sleep heart health study. Circulation 2010, 122(4):352-360. This large prospective follow-up study demonstrated an independent causative relationship between OSA and heart failure. •• Gottlieb DJ, Yenokyan G, Newman AB, O'Connor GT, Punjabi NM, Quan SF, Redline S, Resnick HE, Tong EK, Diener-West M et al: Prospective study of obstructive sleep apnea and incident coronary heart disease and heart failure: the sleep heart health study. Circulation 2010, 122(4):352-360. This large prospective follow-up study demonstrated an independent causative relationship between OSA and heart failure.
12.
go back to reference Chan J, Sanderson J, Chan W, Lai C, Choy D, Ho A, Leung R: Prevalence of sleep-disordered breathing in diastolic heart failure. Chest 1997, 111(6):1488–1493.PubMedCrossRef Chan J, Sanderson J, Chan W, Lai C, Choy D, Ho A, Leung R: Prevalence of sleep-disordered breathing in diastolic heart failure. Chest 1997, 111(6):1488–1493.PubMedCrossRef
13.
go back to reference Javaheri S, Shukla R, Zeigler H, Wexler L: Central sleep apnea, right ventricular dysfunction, and low diastolic blood pressure are predictors of mortality in systolic heart failure. J Am Coll Cardiol 2007, 49(20):2028–2034.PubMedCrossRef Javaheri S, Shukla R, Zeigler H, Wexler L: Central sleep apnea, right ventricular dysfunction, and low diastolic blood pressure are predictors of mortality in systolic heart failure. J Am Coll Cardiol 2007, 49(20):2028–2034.PubMedCrossRef
14.
go back to reference Sin DD, Fitzgerald F, Parker JD, Newton G, Floras JS, Bradley TD: Risk factors for central and obstructive sleep apnea in 450 men and women with congestive heart failure. Am J Respir Crit Care Med 1999, 160(4):1101–1106.PubMed Sin DD, Fitzgerald F, Parker JD, Newton G, Floras JS, Bradley TD: Risk factors for central and obstructive sleep apnea in 450 men and women with congestive heart failure. Am J Respir Crit Care Med 1999, 160(4):1101–1106.PubMed
15.
go back to reference Paulino A, Damy T, Margarit L, Stoica M, Deswarte G, Khouri L, Vermes E, Meizels A, Hittinger L, d’Ortho MP: Prevalence of sleep-disordered breathing in a 316-patient French cohort of stable congestive heart failure. Arch Cardiovasc Dis 2009, 102(3):169–175.PubMedCrossRef Paulino A, Damy T, Margarit L, Stoica M, Deswarte G, Khouri L, Vermes E, Meizels A, Hittinger L, d’Ortho MP: Prevalence of sleep-disordered breathing in a 316-patient French cohort of stable congestive heart failure. Arch Cardiovasc Dis 2009, 102(3):169–175.PubMedCrossRef
16.
go back to reference Redfield MM, Jacobsen SJ, Burnett JC, Jr., Mahoney DW, Bailey KR, Rodeheffer RJ: Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of the heart failure epidemic. Jama 2003, 289(2):194-202.PubMedCrossRef Redfield MM, Jacobsen SJ, Burnett JC, Jr., Mahoney DW, Bailey KR, Rodeheffer RJ: Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of the heart failure epidemic. Jama 2003, 289(2):194-202.PubMedCrossRef
17.
go back to reference Tamura A, Kawano Y, Naono S, Kotoku M, Kadota J: Relationship between beta-blocker treatment and the severity of central sleep apnea in chronic heart failure. Chest 2007, 131(1):130–135.PubMedCrossRef Tamura A, Kawano Y, Naono S, Kotoku M, Kadota J: Relationship between beta-blocker treatment and the severity of central sleep apnea in chronic heart failure. Chest 2007, 131(1):130–135.PubMedCrossRef
18.
go back to reference Chiu KL, Ryan CM, Shiota S, Ruttanaumpawan P, Arzt M, Haight JS, Chan CT, Floras JS, Bradley TD: Fluid shift by lower body positive pressure increases pharyngeal resistance in healthy subjects. Am J Respir Crit Care Med 2006, 174(12):1378–1383.PubMedCrossRef Chiu KL, Ryan CM, Shiota S, Ruttanaumpawan P, Arzt M, Haight JS, Chan CT, Floras JS, Bradley TD: Fluid shift by lower body positive pressure increases pharyngeal resistance in healthy subjects. Am J Respir Crit Care Med 2006, 174(12):1378–1383.PubMedCrossRef
19.
go back to reference • Yumino D, Redolfi S, Ruttanaumpawan P, Su MC, Smith S, Newton GE, Mak S, Bradley TD: Nocturnal rostral fluid shift: a unifying concept for the pathogenesis of obstructive and central sleep apnea in men with heart failure. Circulation 2010, 121(14):1598-1605. This is a recent study demonstrating a unifying mechanism for both OSA and CSA in patients with heart failure and explaining the observed shift between the two types of SDB seen in patients with heart failure on repeated testing. These findings also explain the high prevalence of OSA rather than CSA in patients hospitalized with decompensated heart failure. The implication for this study is that a treatment targeted at decreasing the positional fluid shift in heart failure may impact both central and obstructive sleep apnea positively.PubMedCrossRef • Yumino D, Redolfi S, Ruttanaumpawan P, Su MC, Smith S, Newton GE, Mak S, Bradley TD: Nocturnal rostral fluid shift: a unifying concept for the pathogenesis of obstructive and central sleep apnea in men with heart failure. Circulation 2010, 121(14):1598-1605. This is a recent study demonstrating a unifying mechanism for both OSA and CSA in patients with heart failure and explaining the observed shift between the two types of SDB seen in patients with heart failure on repeated testing. These findings also explain the high prevalence of OSA rather than CSA in patients hospitalized with decompensated heart failure. The implication for this study is that a treatment targeted at decreasing the positional fluid shift in heart failure may impact both central and obstructive sleep apnea positively.PubMedCrossRef
20.
go back to reference Xie A, Skatrud JB, Puleo DS, Rahko PS, Dempsey JA: Apnea-hypopnea threshold for CO2 in patients with congestive heart failure. Am J Respir Crit Care Med 2002, 165(9):1245–1250.PubMedCrossRef Xie A, Skatrud JB, Puleo DS, Rahko PS, Dempsey JA: Apnea-hypopnea threshold for CO2 in patients with congestive heart failure. Am J Respir Crit Care Med 2002, 165(9):1245–1250.PubMedCrossRef
21.
go back to reference Chenuel BJ, Smith CA, Skatrud JB, Henderson KS, Dempsey JA: Increased propensity for apnea in response to acute elevations in left atrial pressure during sleep in the dog. J Appl Physiol 2006, 101(1):76–83.PubMedCrossRef Chenuel BJ, Smith CA, Skatrud JB, Henderson KS, Dempsey JA: Increased propensity for apnea in response to acute elevations in left atrial pressure during sleep in the dog. J Appl Physiol 2006, 101(1):76–83.PubMedCrossRef
22.
go back to reference Dempsey JA: Crossing the apnoeic threshold: causes and consequences. Exp Physiol 2005, 90(1):13–24.PubMedCrossRef Dempsey JA: Crossing the apnoeic threshold: causes and consequences. Exp Physiol 2005, 90(1):13–24.PubMedCrossRef
23.
go back to reference Solin P, Roebuck T, Johns DP, Walters EH, Naughton MT: Peripheral and central ventilatory responses in central sleep apnea with and without congestive heart failure. Am J Respir Crit Care Med 2000, 162(6):2194–2200.PubMed Solin P, Roebuck T, Johns DP, Walters EH, Naughton MT: Peripheral and central ventilatory responses in central sleep apnea with and without congestive heart failure. Am J Respir Crit Care Med 2000, 162(6):2194–2200.PubMed
24.
go back to reference Prabhakar NR, Fields RD, Baker T, Fletcher EC: Intermittent hypoxia: cell to system. Am J Physiol Lung Cell Mol Physiol 2001, 281(3):L524–528.PubMed Prabhakar NR, Fields RD, Baker T, Fletcher EC: Intermittent hypoxia: cell to system. Am J Physiol Lung Cell Mol Physiol 2001, 281(3):L524–528.PubMed
25.
go back to reference Katragadda S, Xie A, Puleo D, Skatrud JB, Morgan BJ: Neural mechanism of the pressor response to obstructive and nonobstructive apnea. J Appl Physiol 1997, 83(6):2048–2054.PubMed Katragadda S, Xie A, Puleo D, Skatrud JB, Morgan BJ: Neural mechanism of the pressor response to obstructive and nonobstructive apnea. J Appl Physiol 1997, 83(6):2048–2054.PubMed
26.
go back to reference Larkin EK, Rosen CL, Kirchner HL, Storfer-Isser A, Emancipator JL, Johnson NL, Zambito AM, Tracy RP, Jenny NS, Redline S: Variation of C-reactive protein levels in adolescents: association with sleep-disordered breathing and sleep duration. Circulation 2005, 111(15):1978–1984.PubMedCrossRef Larkin EK, Rosen CL, Kirchner HL, Storfer-Isser A, Emancipator JL, Johnson NL, Zambito AM, Tracy RP, Jenny NS, Redline S: Variation of C-reactive protein levels in adolescents: association with sleep-disordered breathing and sleep duration. Circulation 2005, 111(15):1978–1984.PubMedCrossRef
27.
go back to reference Bradley TD, Hall MJ, Ando S, Floras JS: Hemodynamic effects of simulated obstructive apneas in humans with and without heart failure. Chest 2001, 119(6):1827–1835.PubMedCrossRef Bradley TD, Hall MJ, Ando S, Floras JS: Hemodynamic effects of simulated obstructive apneas in humans with and without heart failure. Chest 2001, 119(6):1827–1835.PubMedCrossRef
28.
go back to reference Brinker JA, Weiss JL, Lappe DL, Rabson JL, Summer WR, Permutt S, Weisfeldt ML: Leftward septal displacement during right ventricular loading in man. Circulation 1980, 61(3):626–633.PubMed Brinker JA, Weiss JL, Lappe DL, Rabson JL, Summer WR, Permutt S, Weisfeldt ML: Leftward septal displacement during right ventricular loading in man. Circulation 1980, 61(3):626–633.PubMed
29.
go back to reference Wang H, Parker JD, Newton GE, Floras JS, Mak S, Chiu KL, Ruttanaumpawan P, Tomlinson G, Bradley TD: Influence of obstructive sleep apnea on mortality in patients with heart failure. J Am Coll Cardiol 2007, 49(15):1625–1631.PubMedCrossRef Wang H, Parker JD, Newton GE, Floras JS, Mak S, Chiu KL, Ruttanaumpawan P, Tomlinson G, Bradley TD: Influence of obstructive sleep apnea on mortality in patients with heart failure. J Am Coll Cardiol 2007, 49(15):1625–1631.PubMedCrossRef
30.
go back to reference Trinder J, Merson R, Rosenberg JI, Fitzgerald F, Kleiman J, Douglas Bradley T: Pathophysiological interactions of ventilation, arousals, and blood pressure oscillations during cheyne-stokes respiration in patients with heart failure. Am J Respir Crit Care Med 2000, 162(3 Pt 1):808-813.PubMed Trinder J, Merson R, Rosenberg JI, Fitzgerald F, Kleiman J, Douglas Bradley T: Pathophysiological interactions of ventilation, arousals, and blood pressure oscillations during cheyne-stokes respiration in patients with heart failure. Am J Respir Crit Care Med 2000, 162(3 Pt 1):808-813.PubMed
31.
go back to reference Nancy A. Collop WMA, Brian Boehlecke, David Claman et al. Portable Monitoring Task Force for the American Academy of Sleep Medicine: Clinical Guidelines for the Use of Unattended Portable Monitors in the Diagnosis of Obstructive Sleep Apnea in Adult Patients. Journal of Clinical Sleep Medicine 2007, 3(7). Nancy A. Collop WMA, Brian Boehlecke, David Claman et al. Portable Monitoring Task Force for the American Academy of Sleep Medicine: Clinical Guidelines for the Use of Unattended Portable Monitors in the Diagnosis of Obstructive Sleep Apnea in Adult Patients. Journal of Clinical Sleep Medicine 2007, 3(7).
32.
go back to reference Schulz R, Blau A, Borgel J, Duchna HW, Fietze I, Koper I, Prenzel R, Schadlich S, Schmitt J, Tasci S et al: Sleep apnoea in heart failure. Eur Respir J 2007, 29(6):1201–1205.PubMedCrossRef Schulz R, Blau A, Borgel J, Duchna HW, Fietze I, Koper I, Prenzel R, Schadlich S, Schmitt J, Tasci S et al: Sleep apnoea in heart failure. Eur Respir J 2007, 29(6):1201–1205.PubMedCrossRef
33.
go back to reference Pepperell JC, Ramdassingh-Dow S, Crosthwaite N, Mullins R, Jenkinson C, Stradling JR, Davies RJ: Ambulatory blood pressure after therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised parallel trial. Lancet 2002, 359(9302):204–210.PubMedCrossRef Pepperell JC, Ramdassingh-Dow S, Crosthwaite N, Mullins R, Jenkinson C, Stradling JR, Davies RJ: Ambulatory blood pressure after therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised parallel trial. Lancet 2002, 359(9302):204–210.PubMedCrossRef
34.
go back to reference Kaneko Y, Floras JS, Usui K, Plante J, Tkacova R, Kubo T, Ando S, Bradley TD: Cardiovascular effects of continuous positive airway pressure in patients with heart failure and obstructive sleep apnea. N Engl J Med 2003, 348(13):1233–1241.PubMedCrossRef Kaneko Y, Floras JS, Usui K, Plante J, Tkacova R, Kubo T, Ando S, Bradley TD: Cardiovascular effects of continuous positive airway pressure in patients with heart failure and obstructive sleep apnea. N Engl J Med 2003, 348(13):1233–1241.PubMedCrossRef
35.
go back to reference Mansfield DR, Solin P, Roebuck T, Bergin P, Kaye DM, Naughton MT: The effect of successful heart transplant treatment of heart failure on central sleep apnea. Chest 2003, 124(5):1675–1681.PubMedCrossRef Mansfield DR, Solin P, Roebuck T, Bergin P, Kaye DM, Naughton MT: The effect of successful heart transplant treatment of heart failure on central sleep apnea. Chest 2003, 124(5):1675–1681.PubMedCrossRef
36.
go back to reference Bradley TD, Logan AG, Kimoff RJ, Series F, Morrison D, Ferguson K, Belenkie I, Pfeifer M, Fleetham J, Hanly P et al: Continuous positive airway pressure for central sleep apnea and heart failure. N Engl J Med 2005, 353(19):2025–2033.PubMedCrossRef Bradley TD, Logan AG, Kimoff RJ, Series F, Morrison D, Ferguson K, Belenkie I, Pfeifer M, Fleetham J, Hanly P et al: Continuous positive airway pressure for central sleep apnea and heart failure. N Engl J Med 2005, 353(19):2025–2033.PubMedCrossRef
37.
go back to reference Sinha AM, Skobel EC, Breithardt OA, Norra C, Markus KU, Breuer C, Hanrath P, Stellbrink C: Cardiac resynchronization therapy improves central sleep apnea and Cheyne-Stokes respiration in patients with chronic heart failure. J Am Coll Cardiol 2004, 44(1):68–71.PubMedCrossRef Sinha AM, Skobel EC, Breithardt OA, Norra C, Markus KU, Breuer C, Hanrath P, Stellbrink C: Cardiac resynchronization therapy improves central sleep apnea and Cheyne-Stokes respiration in patients with chronic heart failure. J Am Coll Cardiol 2004, 44(1):68–71.PubMedCrossRef
38.
go back to reference Andreas S, Clemens C, Sandholzer H, Figulla HR, Kreuzer H: Improvement of exercise capacity with treatment of Cheyne-Stokes respiration in patients with congestive heart failure. J Am Coll Cardiol 1996, 27(6):1486–1490.PubMedCrossRef Andreas S, Clemens C, Sandholzer H, Figulla HR, Kreuzer H: Improvement of exercise capacity with treatment of Cheyne-Stokes respiration in patients with congestive heart failure. J Am Coll Cardiol 1996, 27(6):1486–1490.PubMedCrossRef
39.
go back to reference Khayat RN, Xie A, Patel AK, Kaminski A, Skatrud JB: Cardiorespiratory effects of added dead space in patients with heart failure and central sleep apnea. Chest 2003, 123(5):1551–1560.PubMedCrossRef Khayat RN, Xie A, Patel AK, Kaminski A, Skatrud JB: Cardiorespiratory effects of added dead space in patients with heart failure and central sleep apnea. Chest 2003, 123(5):1551–1560.PubMedCrossRef
40.
go back to reference Javaheri S: Acetazolamide improves central sleep apnea in heart failure: a double-blind, prospective study. Am J Respir Crit Care Med 2006, 173(2):234–237.PubMedCrossRef Javaheri S: Acetazolamide improves central sleep apnea in heart failure: a double-blind, prospective study. Am J Respir Crit Care Med 2006, 173(2):234–237.PubMedCrossRef
41.
go back to reference Vazir A, Hastings PC, Morrell MJ, Pepper J, Henein MY, Westaby S, Poole-Wilson PA, Cowie MR, Simonds AK: Resolution of central sleep apnoea following implantation of a left ventricular assist device. Int J Cardiol 2010, 138(3):317-319. Vazir A, Hastings PC, Morrell MJ, Pepper J, Henein MY, Westaby S, Poole-Wilson PA, Cowie MR, Simonds AK: Resolution of central sleep apnoea following implantation of a left ventricular assist device. Int J Cardiol 2010, 138(3):317-319.
42.
go back to reference Collop NA: Cheyne-stokes ventilation converting to obstructive sleep apnea following heart transplantation. Chest 1993, 104(4):1288–1289.PubMedCrossRef Collop NA: Cheyne-stokes ventilation converting to obstructive sleep apnea following heart transplantation. Chest 1993, 104(4):1288–1289.PubMedCrossRef
43.
go back to reference Thalhofer SA, Kiwus U, Dorow P: Influence of Orthotopic Heart Transplantation on Breathing Pattern Disorders in Patients with Dilated Cardiomyopathy. Sleep Breath 2000, 4(3):121–126.PubMedCrossRef Thalhofer SA, Kiwus U, Dorow P: Influence of Orthotopic Heart Transplantation on Breathing Pattern Disorders in Patients with Dilated Cardiomyopathy. Sleep Breath 2000, 4(3):121–126.PubMedCrossRef
Metadata
Title
Recognition and Management of Sleep-Disordered Breathing in Chronic Heart Failure
Authors
Rami Kahwash
Donald Kikta
Rami Khayat
Publication date
01-03-2011
Publisher
Current Science Inc.
Published in
Current Heart Failure Reports / Issue 1/2011
Print ISSN: 1546-9530
Electronic ISSN: 1546-9549
DOI
https://doi.org/10.1007/s11897-010-0037-1

Other articles of this Issue 1/2011

Current Heart Failure Reports 1/2011 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.