{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:33:20Z","timestamp":1791995600281,"version":"4.4.0"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[1999,3,23]]},"abstract":"<jats:p>\n            <jats:italic>Background<\/jats:italic>\n            \u2014Nocturnal Cheyne-Stokes respiration (CSR) occurs frequently in patients with chronic heart failure (CHF), and it may be associated with sympathetic activation. The aim of the present study was to evaluate whether CSR could affect prognosis in patients with CHF.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods and Results<\/jats:italic>\n            \u2014Sixty-two CHF patients with left ventricular ejection fraction \u226435%, in NYHA class II to III, underwent clinical evaluation, Doppler echocardiography, ergospirometry, phenylephrine test, Holter recording, and a sleep study to evaluate the occurrence of CSR, expressed as percentage of periodic breathing, and apnea\/hypopnea index (AHI) (ie, the number of apneas and hypopneas per hour of recording). During a mean follow-up of 28\u00b113 months, 15 patients died of cardiac causes. Nonsurvivors were in a higher NYHA functional class than survivors (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.001) and had a more depressed left ventricular ejection fraction (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.03), a shorter deceleration time of early filling (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.05), larger left and right atria (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.05 and\n            <jats:italic>P<\/jats:italic>\n            &lt;0.02, respectively) and a lower peak V\u0307\n            <jats:sc>o<\/jats:sc>\n            <jats:sub>2<\/jats:sub>\n            (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.05). Nonsurvivors also spent a greater percentage of the night in periodic breathing (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.01) with a greater AHI (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.03) and showed lower values of diurnal baroreflex sensitivity (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.05) and of heart rate variability (sdNN:\n            <jats:italic>P<\/jats:italic>\n            &lt;0.01). Multivariate analysis revealed the AHI (\u03c7\n            <jats:sup>2<\/jats:sup>\n            , 10.4;\n            <jats:italic>P<\/jats:italic>\n            &lt;0.01), followed by left atrial area (\u03c7\n            <jats:sup>2<\/jats:sup>\n            , 5.7;\n            <jats:italic>P<\/jats:italic>\n            &lt;0.01), as the only independent and additional predictors of subsequent cardiac death. Patients at very high risk for fatal outcome could be identified by an AHI \u226530\/h and left atria \u226525 cm\n            <jats:sup>2<\/jats:sup>\n            .\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            \u2014The AHI is a powerful independent predictor of poor prognosis in clinically stable patients with CHF. The presence of an AHI \u226530\/h adds prognostic information compared with other clinical, echocardiographic, and autonomic data and identifies patients at very high risk for subsequent cardiac death.\n          <\/jats:p>","DOI":"10.1161\/01.cir.99.11.1435","type":"journal-article","created":{"date-parts":[[2012,6,12]],"date-time":"2012-06-12T00:42:29Z","timestamp":1339461749000},"page":"1435-1440","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":570,"title":["Prognostic Value of Nocturnal Cheyne-Stokes Respiration in Chronic Heart Failure"],"prefix":"10.1161","volume":"99","author":[{"given":"Paola A.","family":"Lanfranchi","sequence":"first","affiliation":[{"name":"From the Division of Cardiology (P.A.L., E.B., G.M., P.G.), Division of Pulmonary Disease (A.B., C.F.D.), and Department of Bioengineering (R.C.), Salvatore Maugeri Foundation, IRCCS, Veruno, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Braghiroli","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology (P.A.L., E.B., G.M., P.G.), Division of Pulmonary Disease (A.B., C.F.D.), and Department of Bioengineering (R.C.), Salvatore Maugeri Foundation, IRCCS, Veruno, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enzo","family":"Bosimini","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology (P.A.L., E.B., G.M., P.G.), Division of Pulmonary Disease (A.B., C.F.D.), and Department of Bioengineering (R.C.), Salvatore Maugeri Foundation, IRCCS, Veruno, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Mazzuero","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology (P.A.L., E.B., G.M., P.G.), Division of Pulmonary Disease (A.B., C.F.D.), and Department of Bioengineering (R.C.), Salvatore Maugeri Foundation, IRCCS, Veruno, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Colombo","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology (P.A.L., E.B., G.M., P.G.), Division of Pulmonary Disease (A.B., C.F.D.), and Department of Bioengineering (R.C.), Salvatore Maugeri Foundation, IRCCS, Veruno, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio F.","family":"Donner","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology (P.A.L., E.B., G.M., P.G.), Division of Pulmonary Disease (A.B., C.F.D.), and Department of Bioengineering (R.C.), Salvatore Maugeri Foundation, IRCCS, Veruno, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pantaleo","family":"Giannuzzi","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology (P.A.L., E.B., G.M., P.G.), Division of Pulmonary Disease (A.B., C.F.D.), and Department of Bioengineering (R.C.), Salvatore Maugeri Foundation, IRCCS, Veruno, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","first-page":"216","volume":"2","year":"1818","unstructured":"Cheyne J. A case of hypoplexy, in which the fleshy part of the heart was converted into fat. Dublin Hosp Rep. 1818;2:216\u2013223.","journal-title":"Dublin Hosp Rep"},{"key":"e_1_3_2_2_2","unstructured":"Stokes W. The Diseases of the Heart and the Aorta. Dublin Ireland: Hodges and Smith; 1854:302\u2013340."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.152.2.7633695"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.97.21.2154"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/16.6.513"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-198501000-00004"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.106.3.780"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.97.5.1220"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(95)00469-6"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.153.1.8542128"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(96)00608-X"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(94)90667-X"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)11144-8"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.93.5.1043"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/clc.4960200609"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1982.53.3.644"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/148.2.330"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/19.suppl_10.S236"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1989.67.5.2101"},{"key":"e_1_3_2_20_2","first-page":"985","volume":"72","year":"1992","unstructured":"Gleeson K, Zwillich CW, White DP. The influence of increasing ventilatory effort on arousal from sleep. Am Rev Respir Dis. 1992;72:985\u2013992.","journal-title":"Am Rev Respir Dis"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199302043280502"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197110142851602"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(92)90990-G"},{"key":"e_1_3_2_24_2","first-page":"A407","volume":"153","year":"1996","unstructured":"Braghiroli A, Lanfranchi P, Sacco C, Giannuzzi P, Donner C. Nocturnal Cheyne-Stokes respiration and impaired baroreflex sensitivity in the follow-up of patients with chronic heart failure. Am J Respir Crit Care Med. 1996;153:A407. 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