Dept. of Cardiology, Heart and Diabetes Centre North-Rhine Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany.
Sleep Med. 2010 Feb;11(2):137-42. doi: 10.1016/j.sleep.2009.09.004. Epub 2010 Jan 12.
Cheyne-Stokes respiration (CSR) is common in patients with congestive heart failure (CHF) and is associated with poor prognosis. The aim of this study was to analyse the characteristics of CSR in patients with varying degrees of impaired left ventricular ejection fraction (LVEF).
A total of 104 patients with CSR (apnea-hypopnea index [AHI]15/h) and exertional dyspnea were divided into FIVE groups according to their LVEF (<20% upto 50%). A subgroup of 22 patients was studied twice: 15 in whom LVEF improved between studies and 7 in whom LVEF deteriorated. Using cardiorespiratory polygraphy recordings, cycle length (CL), apnea length (AL), ventilation length (VL), time to peak ventilation (TTPV), circulatory delay (CD) and VL:AL ratio were determined.
There was no relationship between AHI and impairment of LVEF, but the characteristics of CSR were related to LV function. Comparing the groups with the best LVEF (>50%) and the worst LVEF (<20%), there were significant increases in CL (49+/-17-86+/-23s), AL (21+/-9-31+/-10s), VL (28+/-10-55+/-17s), TTPV (19+/-5-32+/-11s), VL:AL ratio (1.5+/-0.4-1.9+/-0.7s) and CD (29+/-8-49+/-16s). In the subgroup of patients who were studied twice, improvement in EF was associated with a decrease in these parameters.
The current classification of CSR in CHF patients using AHI may be overly simplistic. Parameters such as CL, VL, TTPV and CD are related to cardiac function and could potentially be used for disease monitoring.
潮式呼吸（CSR）在充血性心力衰竭（CHF）患者中很常见，与预后不良相关。本研究旨在分析不同左心室射血分数（LVEF）受损程度的 CSR 患者的特征。
共纳入 104 例 CSR 患者（呼吸暂停-低通气指数[AHI]≥15/h）和运动性呼吸困难，根据 LVEF（<20%至 50%）分为五组。对 22 例患者进行了两次研究：15 例 LVEF 在两次研究之间有所改善，7 例 LVEF 恶化。使用心肺多导睡眠图记录，确定周期长度（CL）、呼吸暂停长度（AL）、通气长度（VL）、峰值通气时间（TTPV）、循环延迟（CD）和 VL:AL 比值。
AHI 与 LVEF 受损之间无相关性，但 CSR 的特征与 LV 功能有关。比较 LVEF 最佳（>50%）和最差（<20%）的两组，CL（49+/-17-86+/-23s）、AL（21+/-9-31+/-10s）、VL（28+/-10-55+/-17s）、TTPV（19+/-5-32+/-11s）、VL:AL 比值（1.5+/-0.4-1.9+/-0.7s）和 CD（29+/-8-49+/-16s）均显著增加。在两次研究的患者亚组中，EF 的改善与这些参数的降低相关。
目前使用 AHI 对 CHF 患者 CSR 的分类可能过于简单。CL、VL、TTPV 和 CD 等参数与心脏功能有关，可能用于疾病监测。
