Key result
In male patients with systolic heart failure, inducible day-time periodic breathing was associated with a greater hypoxic ventilatory response compared to non-inducible patients.
Why the study?
It was unclear whether day-time periodic breathing during wakefulness could be easily induced in systolic heart failure and what physiological and clinical correlates characterize patients susceptible to induction.
Does mild hypoxia induce periodic breathing in male patients with systolic heart failure?
Cross-Sectional (n=46)
No
Does mild hypoxia induce periodic breathing in male patients with systolic heart failure?
Day-time periodic breathing can be safely induced by mild hypoxia in about half of systolic heart failure patients without spontaneous periodic breathing, and is associated with augmented peripheral chemoreceptor sensitivity.
Answers are grounded in this paper and cite their sources.
Links inducible periodic breathing to augmented chemosensitivity; hypothesis-generating for targeted interventions in systolic heart failure.
Spontaneous day-time periodic breathing (sPB) constitutes a common phenomenon in systolic heart failure (HF). However, it is unclear whether PB during wakefulness could be easily induced and what are the physiological and clinical correlates of patients with HF in whom PB induction is possible. Fifty male HF patients (age 60.8 ± 9.8 years, left ventricle ejection fraction 28.0 ± 7.4%) were prospectively screened and 46 enrolled. After exclusion of patients with sPB the remaining underwent trial of PB induction using mild hypoxia (stepwise addition of nitrogen gas to breathing mixture) which resulted in identification of inducible (iPB) in 51%. All patients underwent assessment of hypoxic ventilatory response (HVR) using transient hypoxia and of hypercapnic ventilatory response (HCVR) employing Read’s rebreathing method. The induction trial did not result in any adverse events and minimal SpO 2 during nitrogen administration was ∼85%. The iPB group (vs. non-inducible PB group, nPB) was characterized by greater HVR (0.90 ± 0.47 vs. 0.50 ± 0.26 L/min/%; p <0.05) but comparable HCVR (0.88 ± 0.54 vs. 0.67 ± 0.68 L/min/mmHg; p = NS) and by worse clinical and neurohormonal profile. Mean SpO 2 which induced first cycle of PB was 88.9 ± 3.7%, while in sPB mean SpO 2 preceding first spontaneous cycle of PB was 96.0 ± 2.5%. There was a reverse relationship between HVR and the relative variation of SpO 2 during induced PB ( r = −0.49, p = 0.04). In summary, PB induction is feasible and safe in HF population using simple and standardized protocol employing incremental, mild hypoxia. Pathophysiology of iPB differs from sPB, as it relies mostly on overactive peripheral chemoreceptors. At the same time enhanced HVR might play a protective role against profound hypoxia during iPB.
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Niewiński et al. (2022) conducted a cross-sectional in Systolic heart failure (n=46). Mild hypoxia (nitrogen gas administration) vs. Non-inducible periodic breathing (nPB) group was evaluated on Hypoxic ventilatory response (HVR) (p=<0.05). In male patients with systolic heart failure, inducible day-time periodic breathing was associated with a greater hypoxic ventilatory response compared to non-inducible patients.
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