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射血分数降低与保留的心力衰竭患者的睡眠呼吸障碍

Sleep disordered breathing in heart failure patients with reduced versus preserved ejection fraction.

作者信息

Sekizuka Hiromitsu, Osada Naohiko, Miyake Fumihiko

机构信息

Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan.

Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan.

出版信息

Heart Lung Circ. 2013 Feb;22(2):104-9. doi: 10.1016/j.hlc.2012.08.006. Epub 2012 Oct 26.

Abstract

BACKGROUND

This study aimed to investigate and compare prevalence of sleep disordered breathing (SDB) in Japanese patients with heart failure with reduced ejection fraction (HFrEF) versus those with HF with preserved EF (HFpEF).

METHODS

This study consecutively included 101 Japanese patients (77 males) with de novo CHF. Echocardiography was performed twice, on admission and at discharge. All patients underwent portable overnight polygraphy within one week before discharge. The patients were stratified into two groups based on LVEF on admission, HFrEF (R group; LVEF<50%, n=82) or HFpEF (P group; LVEF≧50%, n=19); the prevalence of SDB and sleep study data were assessed.

RESULTS

When patients with the apnea hypopnea index ≥15 were defined as having SDB, 50% of the study patients had SDB (OSA, 10%; CSA, 39%; MSA, 1%). No significant differences in the prevalence of SDB or sleep data as well as RVSP, E/e' or plasma brain natriuretic peptide (BNP) were found between the two groups.

CONCLUSIONS

SDB was identified in 50% of de novo Japanese HF patients. When E/e', RVSP and plasma BNP did not significantly differ between the two groups, the prevalence of SDB was similar regardless of LVEF.

摘要

背景

本研究旨在调查并比较射血分数降低的日本心力衰竭(HFrEF)患者与射血分数保留的心力衰竭(HFpEF)患者睡眠呼吸障碍(SDB)的患病率。

方法

本研究连续纳入101例初发CHF的日本患者(77例男性)。入院时和出院时各进行一次超声心动图检查。所有患者在出院前一周内接受便携式夜间多导睡眠监测。根据入院时的左室射血分数(LVEF)将患者分为两组,HFrEF(R组;LVEF<50%,n = 82)或HFpEF(P组;LVEF≧50%,n = 19);评估SDB的患病率和睡眠研究数据。

结果

当呼吸暂停低通气指数≥15的患者被定义为患有SDB时,50%的研究患者患有SDB(阻塞性睡眠呼吸暂停,10%;中枢性睡眠呼吸暂停,39%;混合性睡眠呼吸暂停,1%)。两组之间在SDB患病率、睡眠数据以及右室收缩压(RVSP)、E/e'或血浆脑钠肽(BNP)方面均未发现显著差异。

结论

50%的初发日本心力衰竭患者被确诊患有SDB。当两组之间E/e'、RVSP和血浆BNP无显著差异时,无论LVEF如何,SDB的患病率相似。

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