Dynamic ventilatory response to CO2 in congestive heart failure patients with and without central sleep apnea
1 Center for Biomedical Engineering, University of Kentucky, Lexington, Kentucky 40506; 2 Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada T2N 4N1; and 3 Institute of Automatic Control, Silesian Technical University, 44-101 Gliwice, Poland Nonobstructive (i.e., central) sleep...
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Veröffentlicht in: | Journal of applied physiology (1985) 2001-07, Vol.91 (1), p.408-416 |
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Sprache: | eng |
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Zusammenfassung: | 1 Center for Biomedical Engineering, University of Kentucky,
Lexington, Kentucky 40506; 2 Faculty of Medicine, University
of Calgary, Calgary, Alberta, Canada T2N 4N1; and 3 Institute of
Automatic Control, Silesian Technical University, 44-101 Gliwice,
Poland
Nonobstructive (i.e., central) sleep apnea is a major cause
of sleep-disordered breathing in patients with stable congestive heart
failure (CHF). Although central sleep apnea (CSA) is prevalent in this
population, occurring in 40-50% of patients, its pathogenesis is
poorly understood. Dynamic loop gain and delay of the chemoreflex response to CO 2 was measured during wakefulness in CHF
patients with and without CSA by use of a pseudorandom binary
CO 2 stimulus method. Use of a hyperoxic background
minimized responses derived from peripheral chemoreceptors. The
closed-loop and open-loop gain, estimated from the impulse response,
was three times greater in patients with nocturnal CSA
( n = 9) than in non-CSA patients ( n = 9). Loop dynamics, estimated by the 95% response duration time, did
not differ between the two groups of patients. We speculate that an
increase in dynamic gain of the central chemoreflex response to
CO 2 contributes to the genesis of CSA in patients with CHF.
central chemosensitivity; pseudorandom binary stimulation; impulse
response; dynamic loop gain; carbon dioxide |
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ISSN: | 8750-7587 1522-1601 |
DOI: | 10.1152/jappl.2001.91.1.408 |