Doppler Evaluation of Changing Cardiac Dynamics during Cheyne-Stokes Respiration
Although Cheyne-Stokes respiration is a frequent and well-recognized accompaniment of severe cardiac failure and other conditions, the mechanism of the phenomenon of the periodic breathing is not well understood. In patients with congestive heart failure, it has been shown to be a marker of severe hemodynamic derangement.
Cardiovascular changes and derangements occurring during Cheyne-Stokes have been documented both clinically and experimentally; however, only limited insights into the associated hemodynamic changes have been gained. Noninvasive evaluation by Doppler echocardiography provides information about velocities of intracardiac blood flow. Because hemodynamic information can be obtained from Doppler echocardiography with regard to flow velocity profiles, the technique has the capability of providing insight into the cardiovascular changes occurring during Cheyne-Stokes respiration.
The purpose of this report is to evaluate phasic hemodynamics during Cheyne-Stokes respiration using Doppler echocardiography. Link
Fourteen consecutive patients with the clinical diagnosis of Cheyne-Stokes respiration who were referred to the noninvasive laboratory for evaluation of left ventricular function were prospectively studied. Three patients were eliminated from the study due to the presence of significant arrhythmias during the period of apnea, and one patient had a technically inadequate Doppler examination. Thus, ten patients form the basis of the study. The patients were men, with an age range of 60 to 92 years. Nine of the patients had signs and symptoms of severe congestive heart failure and had cardiomyopathic ventricles and were 4 (NYHA functional classification), and one patient had a cerebrovascular accident and normal myocardial function.