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短时间适应性伺服通气治疗对心力衰竭患者心功能的影响。

Effect of short-duration adaptive servo-ventilation therapy on cardiac function in patients with heart failure.

机构信息

Department of Cardiovascular and Respiratory Medicine, Akita University Graduate School of Medicine, Akita, Japan.

出版信息

Circ J. 2012;76(11):2606-13. doi: 10.1253/circj.cj-12-0328. Epub 2012 Jul 31.

Abstract

BACKGROUND

The aim of this study was to investigate whether short-duration adaptive servo-ventilation (ASV) therapy improves cardiac function in heart failure (HF) patients.

METHODS AND RESULTS

Consecutive HF patients (n=86) were divided into 3 groups: group A, ASV for a mean of ≥4 h; group B, ASV for ≥1 to <4 h per day; and group C, no ASV or ASV <1 h. The frequency of ASV use did not significantly differ between groups A (79.3±19.2%) and B (70.9±17.4%). After 6 months, a significant increase in left ventricular ejection fraction (LVEF), significant decrease in plasma brain natriuretic peptide (BNP) and decrease in LV end-diastolic volume (LVEDV) were observed in groups A (LVEF, 5.0±8.1%; BNP, -24.9±33.7%; LVEDV, -6.2±10.1%) and B (LVEF, 3.5±5.5%; BNP, -16.5±24.6%; LVEDV, -5.1±8.2%) as compared with group C (LVEF, -1.5±6.0%, P=0.004, P=0.017; BNP, 2.8±10.2%, P=0.002, P=0.017; LVEDV, 0.8±9.1%, P=0.031, P=0.043). Significant correlation was seen between the total ASV time and changes of LVEF (r=0.369, P=0.002), BNP (r=-0.445, P<0.001), and LVEDV (r=-0.374, P=0.001). Admission rate was lower in groups A (4.1%) and B (7.1%) than in group C (25%, log-rank test; P=0.042, P=0.045). Multivariate analysis showed that the frequency of ASV use was a strong parameter for the improvement of LVEF (coefficient=0.284, standard error=0.035, P=0.019).

CONCLUSIONS

Even a short-duration of ASV therapy may improve cardiac function in HF patients.

摘要

背景

本研究旨在探讨短时间适应性伺服通气(ASV)治疗是否能改善心力衰竭(HF)患者的心功能。

方法和结果

连续 86 例 HF 患者分为 3 组:A 组,ASV 治疗时间平均≥4 h;B 组,ASV 治疗时间≥1 至<4 h/d;C 组,无 ASV 或 ASV<1 h。A 组(79.3±19.2%)和 B 组(70.9±17.4%)的 ASV 使用频率无显著差异。6 个月后,A 组(LVEF 增加 5.0±8.1%,BNP 降低-24.9±33.7%,LVEDV 降低-6.2±10.1%)和 B 组(LVEF 增加 3.5±5.5%,BNP 降低-16.5±24.6%,LVEDV 降低-5.1±8.2%)较 C 组(LVEF 增加 1.5±6.0%,P=0.004,P=0.017;BNP 增加 2.8±10.2%,P=0.002,P=0.017;LVEDV 增加 0.8±9.1%,P=0.031,P=0.043)左心室射血分数(LVEF)、血浆脑钠肽(BNP)和左心室舒张末期容积(LVEDV)明显改善。ASV 总时间与 LVEF(r=0.369,P=0.002)、BNP(r=-0.445,P<0.001)和 LVEDV(r=-0.374,P=0.001)的变化呈显著相关性。A 组(4.1%)和 B 组(7.1%)的入院率低于 C 组(25%,log-rank 检验;P=0.042,P=0.045)。多变量分析显示,ASV 使用频率是 LVEF 改善的一个强参数(系数=0.284,标准误差=0.035,P=0.019)。

结论

即使是短时间的 ASV 治疗也可能改善 HF 患者的心功能。

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