Does the Severity of Central Sleep Apnea Correlate With Respiratory Gas Indexes During Cardiopulmonary Exercise Testing?

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Central sleep apnea (CSA) is thought to arise as a consequence of chronic heart failure. We have attempted to determine the relationship between the severity of CSA and the respiratory gas indexes during cardiopulmonary exercise testing (CPX), indexes well-known to reflect the severity of heart failure. Twenty consecutive cardiac patients (59.0 ± 15.3 years) with CSA underwent CPX. End-tidal PCO2(PETCO2) was measured at rest and at peak exercise as a substitute for PaCO2, along with the peak oxygen uptake (VO2) and the ratio of the increase in ventilation to the increase in CO2output (VE/VCO2 slope). Peak VO2, % peak VO2, and the VE/VCO2 slope of the subjects were 15.5 ± 5.8 mL/min/kg, 52.8 ± 16.7%, and 37.9 ± 12.5, respectively, showing moderate to severely decreased exercise capacity. While PETCO2 at both rest and peak exercise significantly correlated with peak VO2 (r = 0.63 and r = 0.51, respectively) and the VE/VCO2 slope (r = -0.77 and r = -0.91, respectively), none of these 3 parameters correlated with the apnea-hypopnea index. The apnea-hypopnea index in the subjects with lower resting PETCO2 was not notably different from that in the subjects with relatively high PETCO2. Although the severity of CSA is assumed to correlate with the severity of heart failure, and a lowering of PaCO2 during wakefulness is considered to be one of the mechanisms behind CSA, the severity of CSA does not correlate with the respiratory gas indexes of CPX or the level of PETCO2 in cardiac patients with moderate to severely decreased exercise capacity.

Does the Severity of Central Sleep Apnea Correlate With Respiratory Gas Indexes During Cardiopulmonary Exercise Testing?

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