Department of Medicine, University of Toronto, ON, Canada.
Eur Respir J. 2010 Mar;35(3):592-7. doi: 10.1183/09031936.00070509.
In patients with heart failure (HF), the predominant type of sleep apnoea can change over time in association with alterations in circulation time. The aim of this study was to determine whether, in some patients with HF, a spontaneous shift from mainly central (>50% central events) to mainly obstructive (>50% obstructive events) sleep apnoea (CSA and OSA, respectively) over time coincides with improvement in left ventricular ejection fraction (LVEF). Therefore, sleep studies and LVEFs of HF patients with CSA from the control arm of the Canadian Continuous Positive Airway Pressure for Patients with Central Sleep Apnea and Heart Failure (CANPAP) trial were examined to determine whether some converted to mainly OSA and, if so, whether this was associated with an increase in LVEF. Of 98 patients with follow-up sleep studies and LVEFs, 18 converted spontaneously to predominantly OSA. Compared with those in the nonconversion group, those in the conversion group had a significantly greater increase in the LVEF (2.8% versus -0.07%) and a significantly greater fall in the lung-to-ear circulation time (-7.6 s versus 0.6 s). In patients with HF, spontaneous conversion from predominantly CSA to OSA is associated with an improvement in left ventricular systolic function. Future studies will be necessary to further examine this relationship.
在心力衰竭（HF）患者中，与循环时间改变相关，睡眠呼吸暂停的主要类型可能会随时间而变化。本研究旨在确定在某些 HF 患者中，左心室射血分数（LVEF）是否会随着时间的推移从主要中枢性（>50%中枢性事件）向主要阻塞性（>50%阻塞性事件）睡眠呼吸暂停（CSA 和 OSA，分别）自发转变。因此，检查了加拿大持续气道正压通气治疗中枢性睡眠呼吸暂停和心力衰竭患者（CANPAP）试验对照臂中具有 CSA 的 HF 患者的睡眠研究和 LVEF，以确定是否有些患者自发转为主要 OSA，如果是这样，是否与 LVEF 增加有关。在进行了随访睡眠研究和 LVEF 的 98 例患者中，有 18 例自发转为主要 OSA。与未转换组相比，转换组的 LVEF 显著增加（2.8%比-0.07%），肺到耳循环时间显著降低（-7.6 s 比 0.6 s）。在 HF 患者中，从主要 CSA 自发转为 OSA 与左心室收缩功能的改善相关。未来的研究将有必要进一步研究这种关系。
