{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T22:33:22Z","timestamp":1784327602495,"version":"3.55.0"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T00:00:00Z","timestamp":1758758400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Cheyne-Stokes respiration (CSR), a distinct type of sleep-related breathing disorder, is closely associated with heart failure (HF). In clinical practice, it has been observed that some patients with CSR do not present with HF or related symptoms. However, limited studies have investigated this phenomenon. This study aimed to explore whether CSR events may indicate specific cardiac structural\/functional alterations or serve as an early warning sign for HF progression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>We enrolled middle-aged and elderly patients (\u226545 years) hospitalized at Guangdong Provincial Hospital of Traditional Chinese Medicine without a diagnosis or symptoms of HF. Data on medical history, echocardiography, BNP\/NT-proBNP levels, and polysomnography were collected. Participants were categorized into three groups based on PSG results: (1) Sleep-Related breathing disorders with CSR, (2) Sleep-Related breathing disorders without CSR, and (3) no Sleep-Related breathing disorders. Comparative analyses of clinical parameters were performed across groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 171 patients were included. Patients with CSR events exhibited significantly higher BNP\/Nt-proBNP levels and more pronounced cardiac structural remodeling, including left atrial enlargement and elevated E\/e' ratios. Further analysis identified CSR events as independent risk factors for elevated BNP\/Nt-proBNP levels [OR\u2009=\u2009<jats:sans-serif>2<\/jats:sans-serif>.02, 95%CI (1.02\u20133.98), <jats:italic>p<\/jats:italic>\u2009=\u20090.044], left atrial diameter index [OR\u2009=\u2009<jats:sans-serif>3<\/jats:sans-serif>.15, 95%CI (1.50\u20136.64), <jats:italic>p<\/jats:italic>\u2009=\u20090.002], and E\/e\u2019 ratio [OR\u2009=\u2009<jats:sans-serif>15<\/jats:sans-serif>.32, 95%CI (6.48\u201336.22), <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients without overt HF, the presence of CSR events is positively correlated with left ventricular diastolic dysfunction. CSR events may serve as a biomarker for persistent cardiac diastolic impairment or an early indicator of pathological progression toward heart failure with preserved ejection fraction (HFpEF). These findings warrant further longitudinal investigations to validate its predictive value in clinical settings.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2025.1607079","type":"journal-article","created":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T05:29:32Z","timestamp":1758778172000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Positive association between Cheyne-Stokes respiration events and diastolic dysfunction in pre-heart failure: a cross-sectional study with longitudinal implications"],"prefix":"10.3389","volume":"12","author":[{"given":"Cai","family":"Qinghao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Yifan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ouyang","family":"Lijun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Yahui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Zhimin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu","family":"Biyun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,25]]},"reference":[{"key":"B1","article-title":"Cheyne stokes respirations","volume-title":"StatPearls","author":"Rudrappa","year":"2025"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1435","DOI":"10.1161\/01.CIR.99.11.1435","article-title":"Prognostic value of nocturnal Cheyne-Stokes respiration in chronic heart failure","volume":"99","author":"Lanfranchi","year":"1999","journal-title":"Circulation"},{"key":"B3","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1378\/chest.13-0309","article-title":"Left atrial size, chemosensitivity, and central sleep apnea in heart failure","volume":"146","author":"Calvin","year":"2014","journal-title":"Chest"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1103","DOI":"10.5664\/jcsm.10510","article-title":"The prevalence of sleep-disordered breathing and associated risk factors in patients with decompensated congestive heart failure in Mozambique","volume":"19","author":"Lo","year":"2023","journal-title":"J Clin Sleep Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1093\/eurjhf\/hfp057","article-title":"Sleep-disordered breathing in heart failure with normal left ventricular ejection fraction","volume":"11","author":"Bitter","year":"2009","journal-title":"Eur J Heart Fail"},{"key":"B6","doi-asserted-by":"publisher","first-page":"783","DOI":"10.1164\/rccm.201508-1523OC","article-title":"Central sleep-disordered breathing predicts incident atrial fibrillation in older men","volume":"193","author":"May","year":"2016","journal-title":"Am J Respir Crit Care Med"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.790331","article-title":"Cheyne-Stokes breathing as a predictive indicator of heart failure in patients with obstructive sleep apnea; a retrospective case control study using continuous positive airway pressure remote monitoring data","volume":"9","author":"Saito","year":"2022","journal-title":"Front Cardiovasc Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1181","DOI":"10.1007\/s11325-021-02510-0","article-title":"Periodic breathing in patients with stable obstructive sleep apnea on long-term continuous positive airway pressure treatment: a retrospective study using CPAP remote monitoring data","volume":"26","author":"Saito","year":"2022","journal-title":"Sleep Breath"},{"key":"B9","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1136\/thoraxjnl-2011-200927","article-title":"Cheyne\u2013Stokes respiration: friend or foe?","volume":"67","author":"Naughton","year":"2012","journal-title":"Thorax"},{"key":"B10","doi-asserted-by":"publisher","first-page":"2200384","DOI":"10.1183\/13993003.00384-2022","article-title":"Effect of adaptive servo-ventilation for central sleep apnoea in systolic heart failure on muscle sympathetic nerve activity: a SERVE-HF randomised ancillary study","volume":"61","author":"Tamisier","year":"2023","journal-title":"Eur Respir J"},{"key":"B11","volume-title":"Fundamentals of Sleep Medicine","author":"Berry","year":"2012"},{"key":"B12","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1177\/01945998221103800","article-title":"Clinical characteristics and surgical outcomes of obstructive sleep apnea patients with mixed apnea components","volume":"168","author":"Rha","year":"2022","journal-title":"Otolaryngol Head Neck Surg"},{"key":"B13","volume-title":"The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications. 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