{"doi":"10.1002/ejhf.1854","title":"Benefit of buspirone on chemoreflex and central apnoeas in heart failure: a randomized controlled crossover trial","abstract":"Aims Increased chemosensitivity to carbon dioxide (CO 2 ) is an important trigger of central apnoeas (CA) in heart failure (HF), with negative impact on outcome. We hypothesized that buspirone, a 5HT 1A receptor agonist that inhibits serotonergic chemoreceptor neuron firing in animals, can decrease CO 2 chemosensitivity and CA in HF. Methods and results The BREATH study was a randomized, double‐blind, placebo‐controlled, crossover study (EudraCT‐code 2015‐005383‐42). Outpatients with systolic HF (left ventricular ejection fraction <50%) and moderate‐severe CA [nocturnal apnoea‐hypopnoea index (AHI) ≥15 events/h] were randomly assigned to either oral buspirone (15 mg thrice daily) or placebo for 1 week, with a crossover design (1 week of wash‐out). The primary effectiveness endpoint was a decrease in CO 2 chemosensitivity >0.5 L/min/mmHg. The primary safety endpoint was freedom from serious adverse events. Sixteen patients (age 71.3 ± 5.8 years, all males, left ventricular ejection fraction 29.8 ± 7.8%) were enrolled. In the intention‐to‐treat analysis, more patients treated with buspirone (8/16, 50%) had a CO 2 chemosensitivity reduction >0.5 L/min/mmHg from baseline than those treated with placebo (1/16, 6.7%) (difference between groups 43%, 95% confidence interval 14–73%, P = 0.016). Buspirone compared to baseline led to a 41% reduction in CO 2 chemosensitivity ( P = 0.001) and to a reduction in the AHI, central apnoea index and oxygen desaturation index of 42%, 79%, 77% at nighttime and 50%, 78%, 86% at daytime (all P < 0.01); no difference was observed after placebo administration (all P > 0.05). No patient reported buspirone‐related serious adverse events. Conclusions Buspirone reduces CO 2 chemosensitivity and improves CA and oxygen saturation across the 24 h in patients with HF.","journal":"European Journal of Heart Failure","year":2020,"id":62278,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":52,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9633,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":329190,"name":"Chiara Borrelli","orcid":"0000-0001-8464-4230","position":1,"is_corresponding":false},{"id":329191,"name":"Gianluca Mirizzi","orcid":"0000-0003-0149-8974","position":2,"is_corresponding":false},{"id":329192,"name":"George B. Richerson","orcid":"0000-0001-5696-1554","position":3,"is_corresponding":false},{"id":329193,"name":"Michele Emdin","orcid":"0000-0002-8541-1962","position":4,"is_corresponding":false},{"id":329194,"name":"Claudio Passino","orcid":"0000-0002-0723-4753","position":5,"is_corresponding":false},{"id":329189,"name":"Alberto Giannoni","orcid":"0000-0001-9314-2005","position":0,"is_corresponding":true}],"reference_count":39,"raw_metadata":null,"created_at":"2026-07-18T21:10:11.612909Z","pmid":"32441857","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}