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左心室重构与非缺血性收缩功能障碍性心脏病伴睡眠呼吸紊乱相关。

Left ventricle remodelling is associated with sleep-disordered breathing in non-ischaemic cardiopathy with systolic dysfunction.

机构信息

Federation de Cardiologie, AP-HP, Groupe Henri-Mondor Albert-Chenevier, Créteil, France.

出版信息

J Sleep Res. 2011 Mar;20(1 Pt 1):101-9. doi: 10.1111/j.1365-2869.2009.00817.x.

DOI:10.1111/j.1365-2869.2009.00817.x
PMID:20408922
Abstract

Sleep-disordered breathing (SDB) is associated with left ventricle (LV) remodelling in patients with normal LV function. Sleep-disordered breathing is common in chronic heart failure (CHF) with systolic LV dysfunction, and may contribute to LV remodelling and CHF progression. Our aim was to determine the consequence of SDB on LV geometry in patients with CHF. We hypothesised that SDB severity was correlated with the degree of LV hypertrophy (LVH). One-hundred and sixty patients with CHF with a non-ischaemic systolic LV dysfunction were assessed by overnight polygraphy and echocardiography. Patients were classified in four groups according to their apnoea-hypopnoea index (AHI): <5 (no-SDB); 5-14 (mild); 15-29 (moderate); ≥30 (severe). Left ventricular mass index (LVM Ind) was calculated using the usual echocardiographic M-Mode parameters. Their mean age, New York Heart Association and left ventricular ejection fraction were, respectively: 56 ± 13 years, 2.4 ± 0.8 and 30 ± 10%, and 77% were men. Body mass index, interventricular septal and posterior LV wall thicknesses, and LVM Ind were significantly increased in severe SDB versus no-SDB. LVM Ind was correlated to the AHI (R = 0.27, P = 0.0006) and, using logistic regression, AHI was the unique independent factor of LVH in this population. In non-ischaemic CHF, SDB severity is associated with LV remodelling.

摘要

睡眠呼吸障碍(SDB)与左心室(LV)重塑有关,左心室功能正常。睡眠呼吸障碍在收缩性 LV 功能障碍的慢性心力衰竭(CHF)中很常见,可能导致 LV 重塑和 CHF 进展。我们的目的是确定 SDB 对 CHF 患者 LV 几何结构的影响。我们假设 SDB 严重程度与 LV 肥厚(LVH)的程度相关。通过整夜多导睡眠图和超声心动图评估了 160 例患有非缺血性收缩性 LV 功能障碍的 CHF 患者。根据呼吸暂停低通气指数(AHI)将患者分为四组:<5(无 SDB);5-14(轻度);15-29(中度);≥30(重度)。使用常规超声心动图 M 模式参数计算左心室质量指数(LVM Ind)。他们的平均年龄、纽约心脏协会和左心室射血分数分别为:56 ± 13 岁、2.4 ± 0.8 和 30 ± 10%,77%为男性。与无 SDB 相比,重度 SDB 患者的体重指数、室间隔和左室后壁厚度以及 LVM Ind 均显著增加。LVM Ind 与 AHI 呈正相关(R = 0.27,P = 0.0006),并且使用逻辑回归,AHI 是该人群 LVH 的唯一独立因素。在非缺血性 CHF 中,SDB 严重程度与 LV 重塑相关。

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