Clinical Significance of Arterial Blood Gas Analysis for Detection and/or Treatment of Central Sleep Apnea in Patients With Heart Failure

Abstract

To the Editor: In a recent issue of Circulation , Javaheri et al1 demonstrated that sleep-disordered breathing (SDB), including central sleep apnea (CSA) and periodic breathing (eg, Cheyne-Strokes respiration), is extremely common in patients with stable heart failure and that atrial fibrillation, ventricular arrhythmia, and low left ventricular function are associated with sleep apnea in these patients. Because the reversal of SDB by nasal continuous positive pressures and oxygen may lead to improvements in markers of cardiovascular outcome in selected patients with congestive heart failure (CHF), all cardiologists should pay attention to the recent study. However, the mechanisms of SDB in patients with CHF were not extensively discussed in the article. The same authors recently proposed that low Paco2 resulted in ventilatory instability and central apnea during sleep.2 In the previous study, the values of Paco2 were 37±5 and 39±4 mm Hg in patients with SDB and those without SDB, respectively. Although the differences in resting …