Junya Takagawa1, Hidetsugu Asanoi1, Tomoyuki Tobushi2, Naoto Kumagai3, Toshiaki Kadokami2, Kaoru Dohi3, Shuji Joho4, Osamu Wada5, Takashi Koyama6, Nobuhiko Haruki7, Shin-Ichi Ando8, Shin-Ichi Momomura9. 1. Cardiology Division, Imizu Municipal Hospital. 2. Cardiovascular Medicine, Fukuoka Saiseikai Futsukaichi Hospital. 3. Department of Cardiology and Nephrology, Mie University Graduate School of Medicine. 4. Second Department of Internal Medicine, Toyama University Hospital. 5. Cardiovascular Medicine, Japan Community Health Care Organization Takaoka Fushiki Hospital. 6. Cardiovascular Medicine, Akita University Hospital. 7. Cardiovascular Medicine, Wakamatsu Hospital of the University of Occupational and Environmental Health. 8. Sleep Apnea Center, Kyushu University Hospital. 9. Cardiovascular Medicine, Jichi Medical University Saitama Medical Center.
Abstract
BACKGROUND: The respiratory instability frequently observed in advanced heart failure (HF) is likely to mirror the clinical status of worsening HF. The present multicenter study was conducted to examine whether the noble respiratory stability index (RSI), a quantitative measure of respiratory instability, reflects the recovery process from HF decompensation. Methods and Results: Thirty-six of 44 patients hospitalized for worsening HF completed all-night measurements of RSI both at deterioration and recovery phases. Based on the signs, symptoms, and laboratory data during hospitalization, the Central Adjudication Committee identified 22 convalescent patients and 14 patients with less extent of recovery in a blinded manner without any information on RSI or other respiratory variables. The all-night RSI in the convalescent patients was increased from 27.8±18.4 to 34.6±15.8 (P<0.05). There was no significant improvement of RSI, however, in the remaining patients with little clinical improvement. Of the clinical and laboratory variables, on stepwise linear regression modeling, body weight, peripheral edema, and lung congestion were closely related to the RSI of recovered patients and accounted for 56% of the changes in RSI (coefficient of determination, R2=0.56). CONCLUSIONS: All-night RSI, a quantitative measure of respiratory instability, could faithfully reflect congestive signs and clinical status of HF during the recovery process from acute decompensation.
BACKGROUND: The respiratory instability frequently observed in advanced heart failure (HF) is likely to mirror the clinical status of worsening HF. The present multicenter study was conducted to examine whether the noble respiratory stability index (RSI), a quantitative measure of respiratory instability, reflects the recovery process from HF decompensation. Methods and Results: Thirty-six of 44 patients hospitalized for worsening HF completed all-night measurements of RSI both at deterioration and recovery phases. Based on the signs, symptoms, and laboratory data during hospitalization, the Central Adjudication Committee identified 22 convalescent patients and 14 patients with less extent of recovery in a blinded manner without any information on RSI or other respiratory variables. The all-night RSI in the convalescent patients was increased from 27.8±18.4 to 34.6±15.8 (P<0.05). There was no significant improvement of RSI, however, in the remaining patients with little clinical improvement. Of the clinical and laboratory variables, on stepwise linear regression modeling, body weight, peripheral edema, and lung congestion were closely related to the RSI of recovered patients and accounted for 56% of the changes in RSI (coefficient of determination, R2=0.56). CONCLUSIONS: All-night RSI, a quantitative measure of respiratory instability, could faithfully reflect congestive signs and clinical status of HF during the recovery process from acute decompensation.
Entities:
Keywords:
Chronic heart failure; Control of respiration; Lung congestion; Periodic breathing; Respiratory instability