Bitter Thomas, Langer Christoph, Vogt Jürgen, Lange Mathias, Horstkotte Dieter, Oldenburg Olaf
Kardiologische Klinik, Herz- und Diabeteszentrum Nordrhein-Westfalen, Ruhr-Universität Bochum, Bad Oeynhausen, Germany.
Dtsch Arztebl Int. 2009 Mar;106(10):164-70. doi: 10.3238/arztebl.2009.0164. Epub 2009 Mar 6.
Obstructive sleep apnea (OSA) is more common in patients with atrial fibrillation (AFib). Recently, an additional association between central sleep apnea/Cheyne-Stokes respiration (CSA/CSR) and AFib has been described. The aim of this study was to investigate the prevalence and type of sleep-disordered breathing in patients with AFib and normal systolic left ventricular function.
150 patients (110 men and 40 women, aged 66.1 +/- 1.7 years) underwent cardiorespiratory polygraphy, capillary blood gas analysis, measurement of NT-proBNP, and echocardiography to determine the diameter of the left atrium (LAD) and the peak systolic pulmonary artery pressure (PAP).
Sleep-disordered breathing was documented in 74% of all patients with AFib (43% had OSA and 31% had CSA/CSR). Patients with CSA/CSR had a higher PAP, a higher apnea-hypopnea index, a greater LAD, and a lower capillary blood pCO(2) than patients with OSA.
Patients with AFib were found to have not only a high prevalence of obstructive sleep apnea, as has been described previously, but also a high prevalence of CSA/CSR. It remains unknown whether CSA/CSR is more common in AFib because of diastolic dysfunction or whether phenomena associated with CSA/CSR predispose to AFib. Further research on this question is needed.
阻塞性睡眠呼吸暂停（OSA）在心房颤动（AFib）患者中更为常见。最近，还描述了中枢性睡眠呼吸暂停/陈-施呼吸（CSA/CSR）与AFib之间的额外关联。本研究的目的是调查AFib且左心室收缩功能正常患者睡眠呼吸障碍的患病率和类型。
150例患者（110例男性和40例女性，年龄66.1±1.7岁）接受了心肺多导睡眠监测、毛细血管血气分析、NT-proBNP测量以及超声心动图检查，以确定左心房直径（LAD）和肺动脉收缩压峰值（PAP）。
所有AFib患者中74%记录到睡眠呼吸障碍（43%有OSA，31%有CSA/CSR）。与OSA患者相比，CSA/CSR患者的PAP更高、呼吸暂停低通气指数更高、LAD更大且毛细血管血pCO₂更低。
发现AFib患者不仅如先前所述阻塞性睡眠呼吸暂停患病率高，而且CSA/CSR患病率也高。尚不清楚CSA/CSR在AFib中更常见是因为舒张功能障碍，还是与CSA/CSR相关的现象易导致AFib。需要对此问题进行进一步研究。
