Targeting breathlessness in heart failure

Perhaps we should look at a short‐acting opiates, taken akin to a nitrate spray by an angina patient, to enable a physical activity to be competed more easily such as climbing stairs or sexual intercourse, rather than always assuming all drugs need to be present for 24 hours. In this regard, a much...

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Bibliographic Details
Published inESC Heart Failure Vol. 6; no. 6; pp. 1103 - 1104
Main Author Coats, Andrew J. Stewart
Format Journal Article
LanguageEnglish
Published England John Wiley & Sons, Inc 01.12.2019
John Wiley and Sons Inc
Wiley
Subjects
Dyspnea
Exercise
Heart Failure
Humans
Narcotics
Patients
Physical fitness
Sleep apnea
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Summary:Perhaps we should look at a short‐acting opiates, taken akin to a nitrate spray by an angina patient, to enable a physical activity to be competed more easily such as climbing stairs or sexual intercourse, rather than always assuming all drugs need to be present for 24 hours. In this regard, a much earlier trial showed significant efficacy of the mild opiate dihydrocodeine in reducing the sensation of dyspnoea during a progressive exercise test and being associated with a reduction in ventilatory drive, and leading to a significant increase in exercise tolerance, perhaps because it was given specifically timed to the performance of a bout of exercise. Another possibility is that some of the patients have central sleep apnoea where the pathophysiological mechanisms of nocturnal dyspnoea are partly related to chemoreflex hypersensitivity and periodic episodes of hyperventilation.
Bibliography:SourceType-Other Sources-1
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ISSN:2055-5822
2055-5822
DOI:10.1002/ehf2.12556