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Periodic breathing during incremental exercise predicts mortality in patients with chronic heart failure evaluated for cardiac transplantation

Joao J. Leite, MD, PhD^*,*, Alfredo J. Mansur, MD, PhD^*, Humberto F. G. de Freitas, MD^*, Paulo R. Chizola, MD^*, Edimar A. Bocchi, MD, PhD^*, Mario Terra-Filho, MD, PhD^*, J. Alberto Neder, MD, PhD and Geraldo Lorenzi-Filho, MD, PhD^*

^* Division of Respiratory Disease–Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
Centre for Exercise Science and Medicine (CESAME), Institute of Biomedical & Life Sciences (IBLS), University of Glasgow, Glasgow, United Kingdom

View larger version (14K): [in a new window]   Figure 1 A representative example of a patient presenting with exercise-related periodic breathing (EPB). Diagnosis of EPB was based on presence of frequent (at least 3 cycles), regular (standard deviation of three consecutive cycle lengths [] within 20% of their average), and ample (minimum amplitude [h] of 5 l·min–1) minute ventilation (E) oscillations.

View larger version (16K): [in a new window]   Figure 2 Kaplan-Meier survival curve for patients presenting with or not presenting with periodic breathing during dynamic exercise [EPB(+) and EPB(–), respectively]. Note that EPB(+) patients presented a significantly higher time-adjusted mortality rate (p < 0.01), independent of clinical and functional data.