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Central\u00a0sleep apnea is highly prevalent in systolic heart failure, and its effects on sympathovagal balance (SVB) and hemodynamics might depend on relative phase duration and background pathophysiology.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Objective<\/jats:title>\n                <jats:p>This study compared the effects of central apneas in patients with and without systolic heart failure on SVB and hemodynamics during sleep.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>During polysomnography, measures of SVB (heart rate and diastolic blood pressure variability) were non-invasively recorded and analyzed along with baroreceptor reflex sensitivity and hemodynamic parameters (stroke volume index, cardiac index, total peripheral resistance index). Data analysis focused on stable non-rapid eye movement N2 sleep, comparing normal breathing with central sleep apnea in subjects with and without systolic heart failure.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Ten patients were enrolled per group. In heart failure patients, central apneas had neutral effects on SVB (all <jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05 for the high, low, and very low frequency components of heart rate and diastolic blood pressure variability). Patients without heart failure showed an increase in very low and low frequency components of diastolic blood pressure variability in response to central apneas (63\u2009\u00b1\u200918 vs. 39\u2009\u00b1\u20099%; <jats:italic>p<\/jats:italic>\u2009=\u20090.001, 43\u2009\u00b1\u200912 vs. 31\u2009\u00b1\u200915%; <jats:italic>p<\/jats:italic>\u2009=\u20090.002). In all patients, central apneas had neutral hemodynamic effects when analyzed over a period of 10\u00a0min, but had significant acute hemodynamic effects.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Effects of central apneas on SVB during sleep depend on underlying systolic heart failure, with neutral effects in heart failure and increased sympathetic drive in idiopathic central apneas.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11325-020-02144-8","type":"journal-article","created":{"date-parts":[[2020,7,22]],"date-time":"2020-07-22T20:03:16Z","timestamp":1595448196000},"page":"965-977","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Effects of central apneas on sympathovagal balance and hemodynamics at night: impact of underlying systolic heart failure"],"prefix":"10.1007","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8205-1749","authenticated-orcid":false,"given":"Jens","family":"Spiesshoefer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nora","family":"Hegerfeld","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malte Frank","family":"Gerdes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u00f6ren","family":"Klemm","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martha","family":"Gorbachevski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Radke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Izabela","family":"Tuleta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio","family":"Passino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoyi","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Sciarrone","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Winfried","family":"Randerath","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Dreher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Boentert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Giannoni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,7,22]]},"reference":[{"key":"2144_CR1","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.ejheart.2006.08.003","volume":"9","author":"O Oldenburg","year":"2007","unstructured":"Oldenburg O, Lamp B, Faber L, Teschler H, Horstkotte D, T\u00f6pfer V (2007) Sleep-disordered breathing in patients with symptomatic heart failure. 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All participants gave written informed consent to participate in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statement of ethics"}},{"value":"JS is supported by the Else-Kr\u00f6ner-Fresenius Stiftung (Grant SP A109) for this work, by Kommission f\u00fcr Innovative Medizinische Forschung an der Medizinischen Fakult\u00e4t Muenster (IMF Grant SP 11 18 15), by Deutsche Herzstiftung (DHS Grant S\/01\/19), and by the young investigator research support from Scuola Superiore Sant\u2019Anna Pisa (Curriculum Ph.D. in Translational Medicine) and has received travel grants and lecture honoraria from Boehringer Ingelheim and Chiesi (all) outside the present work. MB is supported by Sanofi Genzyme outside this work and has received speaker honoraria and travel grants from Sanofi Genzyme and Loewenstein Medical. WR reports no conflicts of interest in context with the paper, but has received travel grants and speaking fees outside the submitted work from Loewenstein Medical, Weinmann, Philips Respironics, Novartis, Inspire<b>,<\/b> and Boehringer Ingelheim. MD reports to have received travel grants and\/or speaking fees and\/or fees for consulting from Actelion, Astra Zeneca, Bayer, Berlin Chemie, Boehringer, Chiesi, GSK, Hamilton, Heinen und L\u00f6wenstein, Intermune, Linde, Novartis, Pfizer, Philips Respironics, ResMed, Roche<b>,<\/b> and Weinmann outside the present work. NH, MFG, RR, IT, XJ, SK, PS<b>,<\/b> and CP declare no conflicts of interest in the context of this article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}