Bordier Philippe
Hôpital cardiologique du Haut-Lévêque, Avenue de Magellan, 33604 Pessac Cedex, France.
Arch Cardiovasc Dis. 2009 Aug-Sep;102(8-9):651-61. doi: 10.1016/j.acvd.2009.05.012. Epub 2009 Sep 10.
Sleep disorder specialists manage 90% of patients suffering from obstructive sleep apnoea, which affects 10% of the general population. From another perspective, cardiovascular disease specialists are particularly challenged by sleep apnoea, since it affects a large proportion of their patients and its complications are largely cardiovascular. At least 50% of patients with chronic heart failure (HF) suffer from sleep apnoea, predominantly central and/or Cheyne-Stokes respiration as opposed to obstructive sleep apnoea. While its effect on survival remains uncertain, sleep apnoea promotes the progression of chronic HF and is a predictor of poor prognosis. After screening by cardiologists, patients presenting with chronic HF and sleep apnoea should be referred to a sleep disorder specialist for diagnostic confirmation and treatment. In Part I of this review, we describe the diagnostic steps recommended when sleep apnoea is suspected in patients with chronic HF. We also review the definitions of abnormal sleep-related respiratory events and the prevalence, pathophysiology and haemodynamic consequences of sleep apnoea in this patient population.
睡眠障碍专家负责管理90%患有阻塞性睡眠呼吸暂停的患者，阻塞性睡眠呼吸暂停影响着10%的普通人群。从另一个角度来看，心血管疾病专家尤其受到睡眠呼吸暂停的挑战，因为它影响了很大一部分他们的患者，并且其并发症主要是心血管方面的。至少50%的慢性心力衰竭（HF）患者患有睡眠呼吸暂停，主要是中枢性和/或潮式呼吸，而非阻塞性睡眠呼吸暂停。虽然其对生存的影响仍不确定，但睡眠呼吸暂停会促进慢性HF的进展，并且是预后不良的一个预测指标。经过心脏病专家筛查后，患有慢性HF和睡眠呼吸暂停的患者应转诊至睡眠障碍专家处进行诊断确认和治疗。在本综述的第一部分，我们描述了怀疑慢性HF患者存在睡眠呼吸暂停时推荐的诊断步骤。我们还回顾了与睡眠相关的异常呼吸事件的定义，以及该患者群体中睡眠呼吸暂停的患病率、病理生理学和血流动力学后果。
