我们应该息事宁人吗？SERVE-HF研究后射血分数降低的心力衰竭患者中枢性睡眠呼吸暂停治疗的争议
Should We Let Sleeping Dogs Lie? Controversies of Treating Central Sleep Apnoea in HFrEF Following the SERVE-HF Study.
作者信息
Vazir Ali, Bronis Kostantinos, Pearse Simon
机构信息
Royal Brompton Hospital, National Heart and Lung Institute,Imperial College London, London, UK.
出版信息
Card Fail Rev. 2016 Nov;2(2):113-114. doi: 10.15420/cfr.2016:8:2.
Central sleep apnoea (CSA) is common in patients with heart failure (HF), with a prevalence of 20-45 %. It is a marker of severity of HF and is independently associated with increased morbidity and mortality rates in patients with HF. Targeting CSA with adaptive servoventilation (ASV) was postulated to improve outcomes; however, the results of the recent SERVE-HF (Treatment of Sleep-disordered Breathing by Adaptive Servo-ventilation in Heart Failure Patients) trial showed that in patients with CSA and HF with reduced ejection fraction (HFrEF), ASV, despite successfully treating CSA, was associated with increased risk of cardiovascular death compared with medical therapy. In this expert opinion we discuss the controversies of treating CSA in HFrEF following the SERVE-HF study.
中枢性睡眠呼吸暂停（CSA）在心力衰竭（HF）患者中很常见，患病率为20%-45%。它是HF严重程度的一个指标，并且与HF患者发病率和死亡率增加独立相关。有人推测采用适应性伺服通气（ASV）治疗CSA可改善预后；然而，最近的SERVE-HF（心力衰竭患者适应性伺服通气治疗睡眠呼吸障碍）试验结果表明，在射血分数降低的CSA和HF（HFrEF）患者中，ASV尽管成功治疗了CSA，但与药物治疗相比，心血管死亡风险增加。在本专家意见中，我们根据SERVE-HF研究讨论HFrEF中治疗CSA的争议。
Zotero 插件