Impact of voluntary periodic breathing on hemodynamics and autonomic nervous system function in patients with and without heart failure

Background: Although the effect of hyperventilation on hemodynamics and sympathetic nerve activity (SNA) is known in healthy subject, the effects of a Cheyne-Stokes breathing pattern (CSR) in condition of decreased cardiac output and feedback resetting as in heart failure (HF) and pulmonary arterial hypertension (PAH) is currently unknown. Methods: Hemodynamics and SNA (spectral analysis of heart rate, blood pressure variability and baroreceptor reflex sensitivity by sequence method) were noninvasively (TaskForce Monitor, CNSystems, Graz) evaluated in 20 volunteers (13 male, 49±22 years), 20 systolic HF patients (15 male, 68±12 years, LVEF 35±11%) and 20 patients with PAH (8 male, 56±14 years, systolic pulmonary pressure 55±6 mmHg) both at baseline and during a simulation of CSR with a short and with a long cycle length. Results: Simulation of CSR elicited neutral effects on both hemodynamics and SNA in all groups (all p>0.05) except for a 17% (p Conclusions: Voluntary CSR leads to a hyperventilation length dependent decrease in SNA in healthy volunteers but otherwise has neutral effects on hemodynamic and SNA in both HF and PAH.