Latina Jacqueline M, Estes N A Mark, Garlitski Ann C
Department of Medicine, New England Cardiac Arrhythmia Center, The Tufts Cardiovascular Center, Tufts University School of Medicine, 750 Washington Street, Boston, MA 02111, USA.
Pulm Med. 2013;2013:621736. doi: 10.1155/2013/621736. Epub 2013 Feb 26.
In recent years, growing evidence suggests an association between obstructive sleep apnea (OSA), a common sleep breathing disorder which is increasing in prevalence as the obesity epidemic surges, and atrial fibrillation (AF), the most common cardiac arrhythmia. AF is a costly public health problem increasing a patient's risk of stroke, heart failure, and all-cause mortality. It remains unclear whether the association is based on mutual risk factors, such as obesity and hypertension, or whether OSA is an independent risk factor and causative in nature. This paper explores the pathophysiology of OSA which may predispose to AF, clinical implications of stroke risk in this cohort who display overlapping disease processes, and targeted treatment strategies such as continuous positive airway pressure and AF ablation.
近年来,越来越多的证据表明,阻塞性睡眠呼吸暂停(OSA)与心房颤动(AF)之间存在关联。OSA是一种常见的睡眠呼吸障碍,随着肥胖流行趋势的加剧,其患病率也在不断上升;AF是最常见的心律失常。AF是一个代价高昂的公共卫生问题,会增加患者中风、心力衰竭和全因死亡的风险。目前尚不清楚这种关联是基于肥胖和高血压等共同风险因素,还是OSA本身就是一个独立的风险因素且具有因果关系。本文探讨了可能易引发AF的OSA的病理生理学、在这一呈现重叠疾病过程的队列中中风风险的临床意义,以及诸如持续气道正压通气和AF消融等针对性治疗策略。