Division of Cardiovascular Medicine, University of Missouri-Columbia School of Medicine, 5 Hospital Drive, Columbia, MO 65212, USA.
Sleep Med Rev. 2014 Oct;18(5):399-404. doi: 10.1016/j.smrv.2014.02.002. Epub 2014 Feb 13.
Patent foramen ovale (PFO) is a common congenital cardiac abnormality of the atrial septum which occurs in 25% of the population. It allows communication between the right and left atrium enabling right to left shunting of deoxygenated blood (after birth) which may be linked to strokes or transient ischemic attacks. PFO may also have an association with obstructive sleep apnea (OSA). OSA is a common medical condition occurring in 9% of adult males and 4% of adult females. It may increase the risk of cardiovascular disease. OSA causes intermittent hypoxia from episodes of apnea and hypopnea during sleep. Consequently, hypoxic pulmonary vasoconstriction ensues which produces an increased right atrial pressure which may generate a right to left shunt during apneic episodes promoting the occurrence of thromboembolic events. The existence of a PFO may be higher in patients with OSA. The presence of a PFO and OSA may increase the risk of stroke. In this review, the association of PFO and OSA is described along with their implications for cardiovascular disease. The relevant literature and treatment options are discussed to elaborate on the significance of the associated pathology.
卵圆孔未闭（PFO）是一种常见的先天性房间隔异常，发生在 25%的人群中。它允许左右心房之间的沟通，使含氧血从右向左分流（出生后），这可能与中风或短暂性脑缺血发作有关。PFO 也可能与阻塞性睡眠呼吸暂停（OSA）有关。OSA 是一种常见的疾病，发生在 9%的成年男性和 4%的成年女性中。它可能会增加心血管疾病的风险。OSA 在睡眠期间会因呼吸暂停和呼吸不足而导致间歇性缺氧。因此，缺氧性肺血管收缩随之而来，导致右心房压力增加，这可能会在呼吸暂停发作期间产生右向左分流，促进血栓栓塞事件的发生。OSA 患者中 PFO 的存在可能更高。PFO 和 OSA 的存在会增加中风的风险。在这篇综述中，描述了 PFO 和 OSA 的关联及其对心血管疾病的影响。讨论了相关的文献和治疗选择，以阐述相关病理的意义。
