Exertional and nocturnal periodic breathing after successful cardiac transplantation. A case report

Published: April 1, 2021
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We present a case report of a heart failure patient who underwent cardiopulmonary exercise testing and sleep screening 12 months before and after heart transplantation (HTx). Severe Cheyne-Stokes respiration (CSR) with central sleep apnoea (CSA) was identified either before and after HTx, while periodic breathing during exercise vanished. We suggest that optimization of hemodynamics and medical therapy (low dose of diuretic) did not withdraw the central mechanisms underlying the diathesis for CSR-CSA. While periodic breathing during exercise reversal may support a closer link with an exertional central hemodynamic. This observation indirectly neglects the possible unifying mechanistic background of CSR and periodic breathing, during exercise, in this setting.



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Braith RW, Edwards DG. Exercise following heart transplantation. Sports Med 2000;30:171–92. DOI: https://doi.org/10.2165/00007256-200030030-00003
Berry RB, Budhiraja R, Gottlieb DJ, et al. Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med 2015;8:597-619. DOI: https://doi.org/10.5664/jcsm.2172
Corrà U, Pistono M, Mezzani A, et al. Sleep and exertional periodic breathing in chronic heart failure: prognostic importance and interdependence. Circulation 2006;113:44–50. DOI: https://doi.org/10.1161/CIRCULATIONAHA.105.543173
Braver HM, Brandes WC, Kubiet MA, et al. Effect of cardiac transplantation on Cheyne-Stokes respiration occurring during sleep. Am J Cardiol 1995;76:632-4. DOI: https://doi.org/10.1016/S0002-9149(99)80174-X
Kremser CB, O'Toole MF, Leff AR. Oscillatory hyperventilation in severe congestive heart failure secondary to idiopathic dilated cardiomyopathy or to ischemic cardiomyopathy. Am J Cardiol 1987;59:900-5. DOI: https://doi.org/10.1016/0002-9149(87)91116-7
Ribeiro JP, Knutzen A, Rocco MB, et al. Periodic breathing during exercise in severe heart failure. Reversal with milrinone or cardiac transplantation. Chest 1987;92:555-56. DOI: https://doi.org/10.1378/chest.92.3.555
Corrà U, Piepoli M, Giordano A. Difference in prevalence of exertional oscillatory between healthy subjects and patients with cardiovascular disease. Monaldi Arch Chest Disease 2020;90:1203. DOI: https://doi.org/10.4081/monaldi.2020.1203
Mansfield DR, Solin P, Roebuck T, et al. The effect of successful heart transplant treatment of heart failure on central sleep apnea. Chest 2003;124:1675-81. DOI: https://doi.org/10.1378/chest.124.5.1675
Thalhofer SA, Kiwus U, Dorow P. Influence of orthotopic heart transplantation on breathing pattern disorders in patients with dilated cardiomyopathy. Sleep Breath 2000;4:121-5. DOI: https://doi.org/10.1055/s-2000-11569
Khoo MCK. Determinants of ventilatory instability and variability. Respir Physiol 2000;122:167-82. DOI: https://doi.org/10.1016/S0034-5687(00)00157-2

How to Cite

Corrà, Ugo, Fabiana Isabella Gambarin, Marco Gnemmi, and Massimo Pistono. 2021. “Exertional and Nocturnal Periodic Breathing After Successful Cardiac Transplantation. A Case Report”. Monaldi Archives for Chest Disease 91 (2). https://doi.org/10.4081/monaldi.2021.1757.