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Archives of cardiovascular diseases
Volume 102, n° 8-9
pages 651-661 (août 2009)
Doi : 10.1016/j.acvd.2009.05.012
Received : 2 July 2008 ;  accepted : 11 May 2009
Sleep apnoea in patients with heart failure. Part I: Diagnosis, definitions, prevalence, pathophysiology and haemodynamic consequences
Apnée du sommeil et insuffisance cardiaque
 

Figure 1




Figure 1 : 

Detection of sleep apnoea by nocturnal pulse finger oxymetry. Top tracing: recording of normal nocturnal oxymetry. The other tracings are recordings from three different patients, with automatically calculated ODI12, consistent with sleep apnoea. ODI: O2 desaturation index (number of dips in O2 per hour of nocturnal recording); SpO2 : arterial O2 saturation, on the vertical axis. Time in h and min is displayed on the horizontal axis.


Figure 2




Figure 2 : 

Obstructive apnoea documented by nocturnal ventilation polygraphy. The recordings shows typical repetitive apnoeic events, each associated with profound dips in blood O2 saturation and autonomic nervous system instability characterized by marked bradycardia caused by vagal stimulation during apnoea, followed by tachycardia due to sympathetic surge at the end of each apnoeic episode. See text for more detailed explanations.


Figure 3




Figure 3 : 

Obstructive hypopnoea documented by nocturnal ventilation polygraphy. In this example, the variations in heart rate due to autonomic nervous system instability associated with the dips in O2 saturation during each hypopnoeic event are masked by permanent cardiac pacing. See text for more detailed explanations.


Figure 4




Figure 4 : 

Central apnoea documented by nocturnal ventilation polygraphy. Moderate dips in O2 saturation and variations in heart rate are shown in this example, as often observed in central sleep apnoea. See text for more detailed explanations.


Figure 5




Figure 5 : 

Central hypopnoea documented by nocturnal ventilation polygraphy. This recording shows weak respiratory efforts accompanied by an in-phase (as opposed to out-of-phase in obstructive events) decrease in rib cage and abdominal motion, proportional to the decrease in airflow amplitude. The electrocardiogram shows a fixed heart rate due to permanent pacing. Instead of apnoeic events, the tracings show typical Cheyne-Stokes periodicity. See text for more detailed explanations.


Figure 6




Figure 6 : 

Cheyne-Stokes respiration documented by nocturnal ventilation polygraphy. The recording shows an in-phase increasing/decreasing motion of the thorax and abdomen and a proportional increase/decrease in airflow amplitude. The electrocardiogram shows a fixed heart rate due to permanent pacing. See text for more detailed explanations.


Figure 7




Figure 7 : 

Mixed apnoea documented by nocturnal ventilation polygraphy. This example shows marked variations in O2 saturation with a fixed heart rate, due to permanent cardiac pacing. See text for more detailed explanations.

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