Document Detail


Electroencephalographic arousals during sleep do not alter the pressor response to Cheyne-Stokes respiration in subjects with chronic heart failure.
MedLine Citation:
PMID:  18036088     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study examined the influence of electroencephalographic (EEG) arousal on the magnitude and morphology of the pressor response to Cheyne-Stokes respiration (CSR) in subjects with congestive heart failure (CHF). Thirteen subjects with stable CHF (left ventricular ejection fraction, 26 +/- 7%) and CSR (apnea-hypopnea index 52 +/- 15 h(-1)) underwent overnight polysomnography with beat-to-beat measurement of systemic arterial blood pressure (BP). CSR events were divided into those with or without an EEG arousal defined according to the criteria of the American Sleep Disorders Association. The pressor response was quantified in terms of the delta BP change (difference between the minimum BP during apnea and maximum BP during hyperpnea). Changes in the morphology of the pressor response were assessed by subdividing individual respiratory events into six periods (three during apnea: A1, A2, A3; and three during hyperpnea: H1, H2, H3). Considerable fluctuations in BP and heart rate (HR) were observed across the CSR cycle (delta mean BP 20.2 +/- 6.5 mmHg). The presence of an EEG arousal did not alter the amplitude of fluctuations in BP. Mean blood pressure (MBP) increased 21.0 +/- 7.5 mmHg with arousal versus 19.3 +/- 5.8 mmHg without arousal (NS). A repeated measures ANOVA showed no significant interaction between the presence of arousal and the proportional change in mean BP across the six periods, indicating that an EEG arousal had no effect on the morphology of MBP change during CSR [F(5,60) = 1.44, P = 0.22]. This study showed that EEG-defined arousal does not amplify the pressor response to CSR in CHF.
Authors:
Grant N Willson; Ronald R Grunstein; Turkka Kirjavainen; Iven H Young; Amanda J Piper; Colin E Sullivan; Ian Wilcox
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of sleep research     Volume:  16     ISSN:  0962-1105     ISO Abbreviation:  J Sleep Res     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-11-26     Completed Date:  2008-03-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9214441     Medline TA:  J Sleep Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  421-7     Citation Subset:  IM    
Affiliation:
Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Missenden Road, Camperdown, Sydney, NSW 2050, Australia. gnw@med.usyd.edu.au
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Arousal / physiology*
Blood Pressure / physiology*
Cerebral Cortex / physiopathology
Cheyne-Stokes Respiration / physiopathology*
Chronic Disease
Electroencephalography*
Female
Heart Failure / physiopathology*
Heart Rate / physiology
Humans
Male
Middle Aged
Polysomnography*
Pulmonary Ventilation / physiology
Sleep Apnea, Central / physiopathology*
Sleep Apnea, Obstructive / physiopathology
Sleep Stages / physiology
Ventricular Dysfunction, Left / physiopathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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