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无心力衰竭患者睡眠呼吸障碍与室性心律失常的关联

Association of sleep-disordered breathing and ventricular arrhythmias in patients without heart failure.

作者信息

Koshino Yuki, Satoh Makoto, Katayose Yasuko, Yasuda Kyo, Tanigawa Takeshi, Takeyasu Noriyuki, Watanabe Shigeyuki, Yamaguchi Iwao, Aonuma Kazutaka

机构信息

Department of Cardiology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.

出版信息

Am J Cardiol. 2008 Mar 15;101(6):882-6. doi: 10.1016/j.amjcard.2007.10.056. Epub 2008 Feb 6.

Abstract

The prevalence and characteristics of sleep-disordered breathing (SDB) in patients with ventricular arrhythmias, such as premature ventricular complexes and ventricular tachycardia, are unknown. Therefore, this study was conducted to evaluate the prevalence of SDB in patients with severe ventricular arrhythmias and normal left ventricular (LV) function. Thirty-five patients (63% men, mean age 57.4 +/- 13.8 years) underwent a sleep study. All patients had ventricular tachycardia or frequent premature ventricular complexes (>or=300/hour) and had been referred to the cardiology department for medication, catheter ablation therapy, or the implantation of a cardioverter-defibrillator. Patients with heart failure with LV ejection fractions <50% were excluded; in the remaining patients, the mean LV ejection fraction was 63.9 +/- 8.0%. Twenty-one patients (60%) had SDB with apnea-hypopnea indexes >or=5/hour, and the average apnea-hypopnea index was 22.7 +/- 17.9/hour. Twelve patients (34%) had moderate to severe SDB, with an average apnea-hypopnea index of 33.6 +/- 16.6/hour. Central dominant sleep apnea was evident in 3 patients with SDB. The average age and body mass index were significantly higher in patients with SDB than in those without SDB (age 62.0 +/- 12.8 vs 50.6 +/- 12.7 years, body mass index 26.3 +/- 4.0 vs 21.2 +/- 2.0 kg/m2). In conclusion, this study found a high prevalence of SDB in patients with ventricular arrhythmias and normal LV function.

摘要

室性心律失常(如室性早搏和室性心动过速)患者中睡眠呼吸障碍(SDB)的患病率及特征尚不清楚。因此,本研究旨在评估重度室性心律失常且左心室(LV)功能正常的患者中SDB的患病率。35例患者(63%为男性,平均年龄57.4±13.8岁)接受了睡眠研究。所有患者均有室性心动过速或频发室性早搏(≥300次/小时),并因药物治疗、导管消融治疗或植入心脏复律除颤器而被转诊至心内科。左心室射血分数<50%的心力衰竭患者被排除;其余患者的平均左心室射血分数为63.9±8.0%。21例患者(60%)的呼吸暂停低通气指数≥5次/小时,存在SDB,平均呼吸暂停低通气指数为22.7±17.9次/小时。12例患者(34%)有中度至重度SDB,平均呼吸暂停低通气指数为33.6±16.6次/小时。3例SDB患者存在中枢性为主的睡眠呼吸暂停。SDB患者的平均年龄和体重指数显著高于无SDB的患者(年龄62.0±12.8岁对50.6±12.7岁,体重指数26.3±4.0对21.2±2.0kg/m2)。总之,本研究发现室性心律失常且左心室功能正常的患者中SDB的患病率较高。

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