在中枢性睡眠呼吸暂停心力衰竭患者中，肺弥散功能受损与低氧血症负担相关。

Impairment of pulmonary diffusion correlates with hypoxemic burden in central sleep apnea heart failure patients.

作者信息

Fox Henrik, Koerber Britta, Bitter Thomas, Horstkotte Dieter, Oldenburg Olaf

机构信息

Clinic for Cardiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Georgstrasse 11, D-32545 Bad Oeynhausen, Germany.

出版信息

Respir Physiol Neurobiol. 2017 Sep;243:7-12. doi: 10.1016/j.resp.2017.04.011. Epub 2017 Apr 30.

DOI:10.1016/j.resp.2017.04.011

PMID:28467884

Abstract

PURPOSE

Central sleep apnea (CSA) and Cheyne-Stokes respiration (CSR) are highly prevalent in heart failure (HF) and are linked to increased mortality. Impaired pulmonary diffusion capacity [DLCO] and [KCO]) have been suggested to play a key role in CSA-CSR pathophysiology. This study investigated the relationship between HF, CSR, DLCO and KCO in well-characterized HF patients.

METHODS

This prospective study included HF patients with CSR, all patients underwent full overnight polysomnography (PSG) and lung function testing.

RESULTS

A total of 100 patients were included (age 70.7±9.7years, 95% male, body mass index 28.9±5.3kg/m, left ventricular ejection fraction 33.5±7.7%, New York Heart Association class III 65%. DLCO and oxygenation were significantly correlated with hypoxemic burden (p<0.05). Mean oxygen saturation, oxygen desaturation, C-reactive protein level and pH were significantly associated with CSA-CSR severity (p<0.05).

CONCLUSION

The finding that lung diffusion capacity is significantly associated with hypoxemic burden in HF patients with CSA-CSR highlights the important of lung function in HF patients.

摘要

目的

中枢性睡眠呼吸暂停（CSA）和陈-施呼吸（CSR）在心力衰竭（HF）中高度流行，且与死亡率增加相关。肺弥散功能受损（[DLCO]和[KCO]）被认为在CSA-CSR病理生理学中起关键作用。本研究调查了特征明确的HF患者中HF、CSR、DLCO和KCO之间的关系。

方法

这项前瞻性研究纳入了患有CSR的HF患者，所有患者均接受了整夜多导睡眠图（PSG）和肺功能测试。

结果

共纳入100例患者（年龄70.7±9.7岁，95%为男性，体重指数28.9±5.3kg/m，左心室射血分数33.5±7.7%，纽约心脏协会III级65%）。DLCO和氧合与低氧负担显著相关（p<0.05）。平均血氧饱和度、氧饱和度下降、C反应蛋白水平和pH值与CSA-CSR严重程度显著相关（p<0.05）。