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Carotid Body Denervation Attenuates Oscillations in Respiratory Rate and Sympathetic Nerve Activity, and Decreases Apnea/Hypopnea Index in Congestive Heart Failure

Cheyne‐Stokes respiration is associated with increased morbidity and mortality in patients with congestive heart failure(CHF) and commonly coincides with high chemosensitivity. We hypothesized that incidence of disordered breathing patterns would be increased in a rabbit model of pacing‐induced CHF, and that denervation of the carotid body chemoreceptors (CBD) would attenuate these changes. Plethysmography was used to measure resting breathing pattern and the ventilatory responses to hypoxia (Hx) and hypercapnia (Hc). Sympathetic nerve activity was measured directly from the renal nerves (RSNA) of conscious animals. Resting respiratory pattern was quantified by an apnea‐hypopnea index (AHI) and a respiratory oscillation index. RSNA and ventilatory responses to Hx were augmented in CHF, and nearly abolished by CBD. CBD also resulted in a 40% reduction in Hc response. CHF resulted in increased incidence of oscillations in respiratory rate that were accompanied by surges in blood pressure, heart rate, and RSNA. The incidence of these oscillations was reduced after CBD (pre‐pace 26±3/h, CHF 48±5/h, CHF‐CBD 13±7/h). The AHI was increased with CHF and this increase was attenuated after CBD (pre‐pace 9±2, CHF 17±3, CHF‐CBD 5±1). Our findings suggest that CB denervation may be an effective treatment to reduce respiratory instability in CHF patients.