Dursunoğlu Dursun, Dursunoğlu Neşe
Department of Cardiology, Medicine Faculty of Pamukkale University, Denizli, Turkey.
Turk Kardiyol Dern Ars. 2010 Mar;38(2):135-43.
Sleep-disordered breathing is one of the important factors contributing to the development and/or progression of heart failure (HF). This condition is related to recurring attacks of apnea, hypopnea, and hyperpnea, sleep disruptions, arousals, intermittent hypoxemia, hypocapnia, and hypercapnia, and intrathoracic pressure changes. Obstructive sleep apnea (OSA) is characterized by recurrent upper airway obstruction (apnea and hypopnea), increased breathing effort against totally or partially occluded upper airway, and sleep disruptions. Cardiovascular consequences are the most serious complications of OSA and include acute myocardial infarction, heart failure, left/right ventricular dysfunction, arrhythmias, stroke, and systemic and pulmonary hypertension. Cheyne-Stokes respiration and central apneas may also occur in patients with HF. This article reviews the most recent information on the physiopathology, diagnosis, and treatment modalities of obstructive and central apneas in patients with HF.
睡眠呼吸障碍是导致心力衰竭(HF)发生和/或进展的重要因素之一。这种情况与呼吸暂停、低通气和呼吸急促的反复发作、睡眠中断、觉醒、间歇性低氧血症、低碳酸血症和高碳酸血症以及胸内压变化有关。阻塞性睡眠呼吸暂停(OSA)的特征是反复出现上气道阻塞(呼吸暂停和低通气)、对抗完全或部分阻塞的上气道的呼吸努力增加以及睡眠中断。心血管后果是OSA最严重的并发症,包括急性心肌梗死、心力衰竭、左/右心室功能障碍、心律失常、中风以及系统性和肺动脉高压。HF患者也可能出现潮式呼吸和中枢性呼吸暂停。本文综述了HF患者阻塞性和中枢性呼吸暂停的生理病理学、诊断和治疗方式的最新信息。