Lanfranchi Paola A, Somers Virend K
Research Center, Hôpital du Sacré-Coeur. S400, boul. Gouin Ouest, QC H4J ICS, Montréal, Canada.
Respir Physiol Neurobiol. 2003 Jul 16;136(2-3):153-65. doi: 10.1016/s1569-9048(03)00078-8.
Sleep-disordered breathing, namely obstructive sleep apnea (OSA) and central sleep apnea (CSA), are both often encountered in the setting of heart failure (HF), and have distinct differences in terms of prevalence, pathophysiology and consequences. OSA is independently associated with an increased risk for cardiovascular disease and for congestive HF in the general population. It is conceivable that this breathing disorder may have particularly deleterious effects in patients with coexisting heart disease, especially in those with a failing heart. There are considerable data addressing the interaction between OSA and the cardiovascular system, which underscore the importance of an early detection of this breathing disorder, especially in patients with HF. CSA is generally considered a consequence rather than a cause of HF, and is correlated with the severity of hemodynamic impairment. However, when present, it is associated with increased arrhythmic risk and higher cardiac mortality. Potential mechanisms implicated in the genesis of this breathing pattern and the possible therapeutic options, which have been proven to be effective in the clinical setting, are discussed.
睡眠呼吸障碍，即阻塞性睡眠呼吸暂停（OSA）和中枢性睡眠呼吸暂停（CSA），在心力衰竭（HF）患者中均较为常见，且在患病率、病理生理学及后果方面存在明显差异。在普通人群中，OSA与心血管疾病及充血性心力衰竭风险增加独立相关。可以想象，这种呼吸障碍在合并心脏病的患者中，尤其是心力衰竭患者中，可能具有特别有害的影响。有大量数据涉及OSA与心血管系统之间的相互作用，这凸显了早期发现这种呼吸障碍的重要性，尤其是在HF患者中。CSA通常被认为是HF的结果而非原因，且与血流动力学损害的严重程度相关。然而，当存在CSA时，它与心律失常风险增加及心脏死亡率升高相关。本文讨论了这种呼吸模式发生的潜在机制以及已被证明在临床环境中有效的可能治疗选择。
