Jelic Sanja, Le Jemtel Thierry H
Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA.
Curr Heart Fail Rep. 2009 Sep;6(3):169-75. doi: 10.1007/s11897-009-0024-6.
Sleep-disordered breathing (SDB), including obstructive sleep apnea (OSA) and central sleep apnea (CSA), is highly prevalent and frequently unrecognized in patients with chronic heart failure (HF). Untreated SDB may worsen acute decompensation of HF and delay recovery by increasing vascular inflammation and oxidative stress, impeding control of the blood pressure, and promoting arrhythmias. Untreated OSA doubles the risk for developing HF, and patients with HF who develop OSA are thought to have a worse prognosis than patients with HF alone. Similar to the findings in the general population, treatment of OSA appears to reduce cardiovascular morbidity and mortality in HF. The presence of CSA is associated with increased mortality in HF patients. Efficacious suppression of central sleep apnea with continuous positive airway pressure therapy may reduce mortality in HF.
睡眠呼吸障碍（SDB），包括阻塞性睡眠呼吸暂停（OSA）和中枢性睡眠呼吸暂停（CSA），在慢性心力衰竭（HF）患者中非常普遍且常常未被识别。未经治疗的SDB可能会通过增加血管炎症和氧化应激、阻碍血压控制以及促进心律失常，从而加重HF的急性失代偿并延迟恢复。未经治疗的OSA会使发生HF的风险增加一倍，而发生OSA的HF患者被认为比单纯HF患者的预后更差。与普通人群中的研究结果相似，OSA的治疗似乎可以降低HF患者的心血管发病率和死亡率。CSA的存在与HF患者死亡率增加相关。持续气道正压通气治疗有效抑制中枢性睡眠呼吸暂停可能会降低HF患者的死亡率。
