Bordier Philippe, Orazio Sebastien, Hofmann Pauline, Robert Frederic, Bourenane Ghalia
Cardiovascular Hospital of Haut-Leveque, 4eme Ouest, Avenue de Magellan, 33604, Pessac Cedex, France,
Sleep Breath. 2015 Mar;19(1):159-68. doi: 10.1007/s11325-014-0982-0. Epub 2014 Apr 15.
This paper studies the short- and long-term effects of nocturnal oxygen therapy (NOT) on sleep apnea in chronic heart failure (CHF).
We enrolled 51 adults in New York Heart Association (NYHA) heart failure functional classes II or III, ≤45 % left ventricular ejection fraction (LVEF), in a randomized, open, single-center study. Nocturnal cardiorespiratory polygraphy showed sleep apnea [apnea-hypopnea index (AHI) ≥15 events/h] in 33 patients, of whom 19 were randomly assigned to NOT, 3.0 l/min, and 14 to no NOT. The NOT group underwent follow-up polygraphy at 24 h and 6 months, and the no NOT group a single follow-up polygraphy at 6 months.
No significant difference was observed between baseline and 6 months in the no NOT group. In the NOT group, AHI decreased from 36.8 ± 2.6 events/h at baseline to 20.8 ± 3.0 at 24 h and to 18.3 ± 2.4 at 6 months (both P < 0.0001 vs. baseline), due to central AHI changes from 23.3 ± 2.8 events/h at baseline to 8.3 ± 1.6 at 24 h and to 6.1 ± 1.4 at 6 months (both P < 0.0001 vs. baseline). Oxygen desaturation index (ODI) decreased from 33.0 ± 5.2 events/h at baseline to 7.5 ± 0.5 at 24 h and 9.3 ± 2.6 at 6 months (both P < 0.0001 vs. baseline). NOT had no significant effect on obstructive and mixed AHI, quality of life (QOL), NYHA class, and LVEF up to 6 months of follow-up.
NOT decreased central AHI and ODI significantly within 24 h and up to 6 months in CHF patients with sleep apnea, without significantly modifying obstructive and mixed AHI, QOL, and ventricular function.
本文研究夜间氧疗（NOT）对慢性心力衰竭（CHF）患者睡眠呼吸暂停的短期和长期影响。
在一项随机、开放、单中心研究中，我们纳入了51名纽约心脏协会（NYHA）心功能II或III级、左心室射血分数（LVEF）≤45%的成年人。夜间心肺多导睡眠图显示33例患者存在睡眠呼吸暂停[呼吸暂停低通气指数（AHI）≥15次/小时]，其中19例被随机分配接受NOT，吸氧流量为3.0升/分钟，14例不接受NOT。NOT组在24小时和6个月时进行随访多导睡眠图检查，未接受NOT组在6个月时进行一次随访多导睡眠图检查。
未接受NOT组在基线和6个月时未观察到显著差异。在NOT组中，AHI从基线时的36.8±2.6次/小时降至24小时时的20.8±3.0次/小时和6个月时的18.3±2.4次/小时（与基线相比，P均<0.0001），这是由于中枢性AHI从基线时的23.3±2.8次/小时降至24小时时的8.3±1.6次/小时和6个月时的6.1±1.4次/小时（与基线相比，P均<0.0001）。氧饱和度下降指数（ODI）从基线时的33.0±5.2次/小时降至24小时时的7.5±0.5次/小时和6个月时的9.3±2.6次/小时（与基线相比，P均<0.0001）。在长达6个月的随访中，NOT对阻塞性和混合性AHI、生活质量（QOL）、NYHA分级和LVEF均无显著影响。
在合并睡眠呼吸暂停的CHF患者中，NOT在24小时内及长达6个月时均能显著降低中枢性AHI和ODI，而对阻塞性和混合性AHI、QOL及心室功能无显著影响。
