Abstract
Background
The accuracy of Cheyne-Stokes breathing as a sign of left ventricular dysfunction
and its overall prognostic significance are unknown.
Methods
Between 2001 and 2006, the author examined 386 inpatients at a Department of Veterans
Affairs Medical Center and compared the finding of Cheyne-Stokes breathing and its
cycle length with the patients' echocardiographic ejection fraction (EF) and 5-year
survival.
Results
A total of 45 of 386 patients (11.7%) had Cheyne-Stokes breathing. Two variables were
independently associated with Cheyne-Stokes breathing: reduced EF (P<.001) and age>80 years (P=.006). The presence of Cheyne-Stokes breathing increased the probability of a markedly
reduced EF (ie, EF<40%; likelihood ratio, 5.3; 95% confidence interval, 3.1-9), especially in patients
aged≤80 years (likelihood ratio, 7.8; 95% confidence interval, 3.9-15.5). The finding was
present in 1 of 3 affected patients (sensitivity=34%). The correlation between cycle length and EF was poor (r=0.23, P=.14). The 5-year survival of patients with Cheyne-Stokes breathing (37.2%) was similar
to that of patients without the finding (42.9%, P=.18, log-rank test).
Conclusions
In hospitalized patients, Cheyne-Stokes breathing increases the probability of left
ventricular dysfunction. It is present in 1 of 3 patients with markedly reduced EF.
When detected during physical examination, Cheyne-Stokes breathing does not indicate
worse prognosis.
Keywords
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Article info
Publication history
Published online: March 29, 2013
Footnotes
Funding: None.
Conflict of Interest: The author receives royalties from WB Saunders for his textbook Evidence-based Physical Diagnosis (3rd ed).
Authorship: The author is solely responsible for the content of this manuscript.
Identification
Copyright
Published by Elsevier Inc.
