The Breathless Heart

This book systematically focuses on central sleep apneas, analyzing their relationship especially with heart failure and discussing recent research results and emerging treatment strategies based on feedback modulation. The opening chapters present historical background information on Cheyne-Stokes respiration (CSR), clarify terminology, and explain the mechanics and chemistry of respiration. Following a description of the physiology of respiration, the pathophysiology underlying central apneas in different disorders and particularly in heart failure is discussed. The similarities and differences of obstructive and central apneas are then considered. The book looks beyond the concept of sleep apnea to daytime CSR and periodic breathing during effort and contrasts the opposing views of CSR as a compensatory phenomenon or as detrimental to the failing heart. The diagnostic tools currently in use for the detection of CSR are thoroughly reviewed, with guidance on interpretation of findings. The book concludes by describing the various forms of treatment that are available for CSR and by explaining how to select patients for treatment.

Focuses systematically on central sleep apneas Has a strong pathophysiological background, encompassing not only heart failure but also other diseases related to central apneas Describes current lines of research on central sleep apnea treatment Assists in patient selection for treatment

Autorentext

Michele Emdin got his degree in 1983 and specialized in Cardiovascular Diseases at the Universities of Pisa and Milano, Italy. He started working at the CNR Foundation Gabriele Monasterio in Pisa, Italy, right in 1983, within the Sant'Anna Hospital in Pisa. He worked as visiting assistant professor in Sao Paulo, Brazil, Boston, USA, and London, UK. Beside his important teaching activity started back in 1999, the research avenues he is pursuing are: serum GGT as cardiovascular risk factor, heart failure, ischemic cardiomyopathy, nervous and endocrine control of cardiovascular system. He is author of more than 190 papers and published a book with Springer already on natriuretic peptides.

Alberto Giannoni works as a cardiologist and researcher at the Fondazione Toscana Gabriele Monasterio in Pisa, Italy. He attended his PhD on cardiorespiratory interactions at the Scuola Superiore Sant'Anna, Pisa, Italy and at the Imperial College, London, UK. His main research interest focuson Cheyne-Stokes respiration and feed-back systems, chemoreflex, baroreflex and ergoreflex, in heart failure.

Claudio Passino is Assistant Professor of Cardiovascular Medicine at the Scuola Superiore Sant'Anna in Pisa. He specialized in cardiology and sports medicine. His main research interests focus on neuroendocrine regulation of the cardiovascular system, high altitude cardiac adaptation, evaluation of new risk factors in coronary artery disease.

Inhalt
1 Historical background and glossary of the apnea phenomenon.- 2 Mechanics and chemistry of respiration in health.- 3 Hypopneas and apneas as physiological and pathological phenomena throughout life.- 4 Pathophysiology of central apneas in heart failure.- 5 The importance of visceral feedbacks: focus on chemoreceptors.- 6 The apneas before and after heart failure.- 7 Not only sleep apnea: the awake apneas of the failing heart.- 8 Periodic breathing during effort and central apneas in heart failure: siblings, cousins or what else?.- 9 To breath or not to breath--that is the question.- 10 Diagnostic tools: the easier, the better.- 11 Diagnostic tools: messages from implanted devices.- 12 Targeting and treating apneas.- 13 Final remarks.