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To Breathe, or Not to Breathe: That Is the Question

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The Breathless Heart

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Abstract

Central apnea and specifically Cheyne-Stokes respiration represents a very common phenomenon in the context of systolic heart failure (HF) and has been associated with several neurohormonal and hemodynamic alterations that connote a negative clinical profile that ultimately leads to adverse prognosis. However, the negative consequences of the treatments proposed so far to tackle this phenomenon have raised concerns about the real connotation of central apnea in the context of systolic HF, specifically, whether CSR represent a neutral phenomenon or even a compensatory one.

Due to the increasing consideration given to this topic, an attempt to systematically deal with this dilemma is anticipated; for this reason, the following chapter encompasses the literature regarding both the arguments and tries to summarize their pros and cons and provide future directions for improving both research attempts and clinical care.

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Abbreviations

ACE:

Angiotensin converting enzyme

AHI:

Apnea-hypopnea index

AT-1:

Angiotensin receptor 1

CPAP:

Continuous positive airway pressure

CSR:

Cheyne-Stokes respiration

HF:

Heart failure

LA:

Left atrium

LVEF:

Left ventricular ejection fraction

MRA:

Mineralocorticoid receptor antagonist

MSNA:

Muscle sympathetic nerve activity

NE:

Norepinephrine

NT-proBNP:

N-terminal fragment of pro-brain natriuretic peptide

NYHA:

New York Heart Association

OSA:

Obstructive sleep apnea

PSG:

Polysomnography

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Authors and Affiliations

  1. Institute of Life Sciences, Scuola Superiore Sant’Anna, Pisa, Italy

    Gianluca Mirizzi MD, Claudio Passino MD & Michele Emdin MD, PhD

  2. Division of Cardiology and Cardiovascular Medicine, Fondazione Toscana G. Monasterio, Pisa, Italy

    Gianluca Mirizzi MD, Alberto Giannoni MD, PhD, Claudio Passino MD & Michele Emdin MD, PhD

Authors
  1. Gianluca Mirizzi MD
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  2. Alberto Giannoni MD, PhD
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  3. Claudio Passino MD
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  4. Michele Emdin MD, PhD
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Correspondence to Gianluca Mirizzi MD .

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Editors and Affiliations

  1. Fondazione Toscana Gabriele Monasterio, Pisa, Italy

    Michele Emdin

  2. Fondazione Toscana Gabriele Monasterio, Pisa, Italy

    Alberto Giannoni

  3. Fondazione Toscana Gabriele Monasterio, Pisa, Italy

    Claudio Passino

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Mirizzi, G., Giannoni, A., Passino, C., Emdin, M. (2017). To Breathe, or Not to Breathe: That Is the Question. In: Emdin, M., Giannoni, A., Passino, C. (eds) The Breathless Heart. Springer, Cham. https://doi.org/10.1007/978-3-319-26354-0_9

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  • DOI: https://doi.org/10.1007/978-3-319-26354-0_9

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