Department of Cardiology, Heart and Diabetes Center North Rhine Westphalia, Ruhr-University Bochum, Georgstrasse 11, D-32545 Bad Oeynhausen, Germany.
Circ J. 2012;76(10):2305-17. doi: 10.1253/circj.cj-12-0689. Epub 2012 Sep 7.
Sleep-disordered breathing (SDB) with predominant obstructive or central sleep apnea (OSA/CSA) with Cheyne-Stokes respiration (CSR) is a common, but underestimated and underappreciated, comorbidity in patients with heart failure (HF). Regardless of the type of HF (systolic or diastolic) or its etiology (ischemic, non-ischemic, valvular etc), the prevalence of SDB is remarkably high in this patient group, at 70-76%. Even more so in HF than in the general population, OSA and CSA in particular are independently associated with an impaired prognosis. This review details the pathophysiology of CSA-CSR in HF, highlights the challenges and tools available for diagnosis, explains the concept of adaptive servoventilation (ASV) therapy, and summarizes the existing literature on the use of ASV therapy in HF patients in general and HF with reduced ejection fraction in particular.
以阻塞性或中枢性睡眠呼吸暂停（OSA/CSA）为主，伴有 Cheyne-Stokes 呼吸（CSR）的睡眠障碍呼吸（SDB）是心力衰竭（HF）患者中一种常见但被低估和未被充分认识的共病。无论 HF 的类型（收缩性或舒张性）或病因（缺血性、非缺血性、瓣膜性等）如何，SDB 在该患者群体中的患病率都非常高，高达 70-76%。在 HF 中比在一般人群中更为明显，特别是 OSA 和 CSA 与预后不良独立相关。这篇综述详细介绍了 CSA-CSR 在 HF 中的病理生理学，强调了诊断可用的挑战和工具，解释了适应性伺服通气（ASV）治疗的概念，并总结了关于 ASV 治疗在一般 HF 患者和射血分数降低的 HF 患者中的应用的现有文献。
