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确定慢性心力衰竭患者睡眠呼吸障碍的患病率和预测因素:SCHLA-HF 登记研究的原理和设计。

Determining the prevalence and predictors of sleep disordered breathing in patients with chronic heart failure: rationale and design of the SCHLA-HF registry.

机构信息

Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany.

出版信息

BMC Cardiovasc Disord. 2014 Apr 9;14:46. doi: 10.1186/1471-2261-14-46.

Abstract

BACKGROUND

The objective of the SCHLA-HF registry is to investigate the prevalence of sleep-disordered breathing (SDB) in patients with chronic heart failure with reduced left ventricular systolic function (HF-REF) and to determine predictors of SDB in such patients.

METHODS

Cardiologists in private practices and in hospitals in Germany are asked to document patients with HF-REF into the prospective SCHLA-HF registry if they meet predefined inclusion and exclusion criteria. Screening was started in October 2007 and enrolment was completed at the end of May 2013. After enrolment in the registry, patients are screened for SDB. SDB screening is mainly undertaken using the validated 2-channel ApneaLink™ device (nasal flow and pulse oximetry; ResMed Ltd., Sydney, Australia). Patients with a significant number of apneas and hypopneas per hour recording time (AHI ≥15/h) and/or clinical symptoms suspicious of SDB will be referred to a cooperating sleep clinic for an attended in-lab polysomnography with certified scoring where the definite diagnosis and, if applicable, the differentiation between obstructive and central sleep apnea will be made. Suggested treatment will be documented.

DISCUSSION

Registries play an important role in facilitating advances in the understanding and management of cardiovascular disease. The SCHLA-HF registry will provide consistent data on a large group of patients with HF-REF that will help to answer questions on the prevalence, risk factors, gender differences and stability of SDB in these patients by cross-sectional analyses. Further insight into the development of SDB will be gained by extension of the registry to include longitudinal data.

摘要

背景

SCHLA-HF 登记研究的目的是调查伴有左心室收缩功能降低的慢性心力衰竭(HF-REF)患者中睡眠呼吸障碍(SDB)的流行情况,并确定此类患者中 SDB 的预测因素。

方法

德国的私人诊所和医院的心脏病专家如果符合预设的纳入和排除标准,将被要求在前瞻性 SCHLA-HF 登记中记录 HF-REF 患者。筛查于 2007 年 10 月开始,于 2013 年 5 月底完成登记。登记后,对患者进行 SDB 筛查。SDB 筛查主要使用经过验证的双通道 ApneaLink™设备(鼻气流和脉搏血氧饱和度;ResMed Ltd.,澳大利亚悉尼)进行。对于每小时记录时间有明显数量的呼吸暂停和低通气(AHI≥15/h)和/或有 SDB 临床症状可疑的患者,将被转介到合作的睡眠诊所进行有证评分的过夜多导睡眠图检查,以明确诊断,如果适用,区分阻塞性和中枢性睡眠呼吸暂停。将记录建议的治疗方法。

讨论

登记在促进对心血管疾病的理解和管理方面发挥着重要作用。SCHLA-HF 登记将提供大量 HF-REF 患者的一致数据,通过横断面分析有助于回答这些患者中 SDB 的流行情况、危险因素、性别差异和稳定性问题。通过扩展登记以纳入纵向数据,将进一步深入了解 SDB 的发展。

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