central sleep apnoea
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Thorax ◽  
2021 ◽  
pp. thoraxjnl-2021-218003
Author(s):  
Sébastien Baillieul ◽  
Sébastien Bailly ◽  
Olivier Detante ◽  
Sarah Alexandre ◽  
Marie Destors ◽  
...  

RationaleSleep-disordered breathing (SDB) is highly prevalent after stroke. The clinical and ventilatory chemosensitivity characteristics of SDB, namely obstructive, central and coexisting obstructive and central sleep apnoea (coexisting sleep apnoea) following stroke are poorly described.ObjectiveTo determine the respective clinical and ventilatory chemosensitivity characteristics of SDB at least 3 months after a first ischaemic stroke.MethodsCross-sectional analysis of a prospective, monocentric cohort conducted in a university hospital. 380 consecutive stroke or transient ischaemic attack patients were screened between December 2016 and December 2019.Measurements and main resultsFull-night polysomnography, and hypercapnic ventilatory response were performed at a median (Q1; Q3) time from stroke onset of 134.5 (97.0; 227.3) days. 185 first-time stroke patients were included in the analysis. 94 (50.8%) patients presented no or mild SDB (Apnoea-Hypopnoea Index <15 events/hour of sleep) and 91 (49.2%) moderate to severe SDB, of which 52 (57.1%) presented obstructive sleep apnoea and 39 (42.9%) coexisting or central sleep apnoea. Obstructive sleep apnoea patients significantly differed regarding their clinical presentation from patients with no or mild SDB, whereas there was no difference with coexisting and central sleep apnoea patients. The latter presented a higher frequency of cerebellar lesions along with a heightened hypercapnic ventilatory response compared with no or mild SDB patients.ConclusionSDB in first-time stroke patients differ in their presentation by their respective clinical traits and ventilatory chemosensitivity characteristics. The heightened hypercapnic ventilatory response in coexisting and central sleep apnoea stroke patients may orientate them to specific ventilatory support.



Thorax ◽  
2021 ◽  
pp. thoraxjnl-2021-217694
Author(s):  
Winfried J Randerath ◽  
Michael Arzt


2021 ◽  
pp. 00147-2021
Author(s):  
Christoph Fisser ◽  
Jannis Bureck ◽  
Lara Gall ◽  
Victoria Vaas ◽  
Jörg Priefert ◽  
...  

Cheyne-Stokes respiration (CSR) may trigger ventricular arrhythmia in patients with heart failure with reduced ejection fraction (HFrEF) and central sleep apnoea (CSA). This study determined the prevalence and predictors of a high nocturnal ventricular arrhythmia burden in patients with HFrEF and CSA (with and without CSR) and to evaluate the temporal association between CSR and the ventricular arrhythmia burden.This cross-sectional ancillary analysis included 239 participants from the SERVE-HF major sub-study who had HFrEF and CSA, and nocturnal ECG from polysomnography. CSR was stratified in ≥20% and <20% of total recording time (TRT). High burden of ventricular arrhythmia was defined as >30 premature ventricular complexes (PVCs) per hour of TRT. A sub-analysis was performed to evaluate the temporal association between CSR and ventricular arrhythmias in sleep stage N2.High ventricular arrhythmia burden was observed in 44% of patients. In multivariate logistic regression analysis, male sex, lower systolic blood pressure, non-use of antiarrhythmic medication and CSR ≥20% were significantly associated with PVC >30/h (odds ratio [95% confidence interval]: 5.49 [1.51–19.91], p=0.010; 0.98 [0.97–1.00], p=0.017; 5.02 [1.51–19.91], p=0.001; and 2.22 [1.22–4.05]; p=0.009; respectively). PVCs occurred more frequently during sleep phases with versus without CSR (median [interquartile range]: 64.6 [24.8–145.7] versus 34.6 [4.8–75.2]/h N2 sleep; p=0.006).Further mechanistic studies and arrhythmia analysis of major randomised trials evaluating the effect treating CSR on ventricular arrhythmia burden and arrhythmia-related outcomes are warranted to understand how these data match with the results of the parent SERVE-HF study.



Heart ◽  
2021 ◽  
pp. heartjnl-2020-317888
Author(s):  
Shuhei Yamamoto ◽  
Takayoshi Yamaga ◽  
Shohei Kawachi ◽  
Manaka Shibuya ◽  
Kenichi Nishie




2020 ◽  
Vol 8 (8) ◽  
Author(s):  
Arnaud Prigent ◽  
Anne‐Laure Serandour ◽  
Régis Luraine ◽  
Jean Sébastien Poineuf ◽  
Christian Bosseau ◽  
...  


2020 ◽  
Vol 6 (2) ◽  
pp. 00334-2019 ◽  
Author(s):  
Sebastian R. Ott ◽  
Francesco Fanfulla ◽  
Silvia Miano ◽  
Thomas Horvath ◽  
Andrea Seiler ◽  
...  

Sleep-disordered breathing (SDB) is frequent in patients with acute stroke. Little is known, however about the evolution of SDB after stroke. Most of our knowledge stems from smaller cohort studies applying limited cardiopulmonary sleep recordings or from cross-sectional data collected in different populations.This study aims to determine prevalence, type and intra-individual evolution of SDB based on full-night polysomnography (PSG) in acute stroke and 3 months thereafter. Furthermore, we aimed to identify predictors of SDB in the acute and chronic phase and to evaluate associations between SDB and functional outcome at 3 months (M3).A total of 166 patients with acute cerebrovascular events were evaluated by full PSG at baseline and 105 again at M3. The baseline prevalence of SDB (apnoea–hypopnoea index (AHI)>5·h−1) was 80.5% and 25.4% of the patients had severe SDB (AHI>30·h−1). Obstructive sleep apnoea was more prevalent than central sleep apnoea (83.8% versus 13%). Mean±SD AHI was 21.4±17.6·h−1and decreased significantly at M3 (18±16.4·h−1; p=0.018). At M3, 91% of all patients with baseline SDB still had an AHI>5·h−1 and in 68.1% the predominant type of SDB remained unchanged (78.9% in obstructive sleep apnoea and 44.4% in central sleep apnoea). The only predictors of SDB at baseline were higher age and body mass index and in the chronic phase additionally baseline AHI. Baseline AHI was associated with functional outcome (modified Rankin score >3) at M3.The high prevalence of SDB in acute stroke, its persistence after 3 months, and the association with functional outcome supports the recommendation for a rapid SDB screening in stroke patients.



2020 ◽  
Vol 7 (2) ◽  
pp. 503-511 ◽  
Author(s):  
João Pedro Ferreira ◽  
Kévin Duarte ◽  
Holger Woehrle ◽  
Martin R. Cowie ◽  
Karl Wegscheider ◽  
...  


2020 ◽  
Vol 271 ◽  
pp. 103286 ◽  
Author(s):  
Fabian Roder ◽  
Birgit Wellmann ◽  
Thomas Bitter ◽  
Henrik Fox ◽  
Anke Türoff ◽  
...  


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