Cardiology Division, Imizu Municipal Hospital.
Cardiovascular Medicine, Fukuoka Saiseikai Futsukaichi Hospital.
Circ J. 2018 Dec 25;83(1):164-173. doi: 10.1253/circj.CJ-18-0519. Epub 2018 Nov 13.
The respiratory instability frequently observed in advanced heart failure (HF) is likely to mirror the clinical status of worsening HF. The present multicenter study was conducted to examine whether the noble respiratory stability index (RSI), a quantitative measure of respiratory instability, reflects the recovery process from HF decompensation.
Thirty-six of 44 patients hospitalized for worsening HF completed all-night measurements of RSI both at deterioration and recovery phases. Based on the signs, symptoms, and laboratory data during hospitalization, the Central Adjudication Committee identified 22 convalescent patients and 14 patients with less extent of recovery in a blinded manner without any information on RSI or other respiratory variables. The all-night RSI in the convalescent patients was increased from 27.8±18.4 to 34.6±15.8 (P<0.05). There was no significant improvement of RSI, however, in the remaining patients with little clinical improvement. Of the clinical and laboratory variables, on stepwise linear regression modeling, body weight, peripheral edema, and lung congestion were closely related to the RSI of recovered patients and accounted for 56% of the changes in RSI (coefficient of determination, R=0.56).
All-night RSI, a quantitative measure of respiratory instability, could faithfully reflect congestive signs and clinical status of HF during the recovery process from acute decompensation.
晚期心力衰竭（HF）中经常观察到的呼吸不稳定可能反映出 HF 恶化的临床状态。本多中心研究旨在探讨定量呼吸不稳定指标（RSI）是否反映 HF 失代偿恢复过程。
44 例因 HF 恶化而住院的患者中有 36 例完成了恶化和恢复阶段的整个夜间 RSI 测量。根据住院期间的体征、症状和实验室数据，中心裁决委员会以盲法方式确定了 22 例恢复期患者和 14 例恢复程度较低的患者，而不了解 RSI 或其他呼吸变量的信息。恢复期患者的整夜 RSI 从 27.8±18.4 增加到 34.6±15.8（P<0.05）。然而，在临床改善不大的其余患者中，RSI 并没有显著改善。在逐步线性回归模型中，体重、周围水肿和肺部充血与恢复患者的 RSI 密切相关，占 RSI 变化的 56%（决定系数，R=0.56）。
整夜 RSI，一种定量呼吸不稳定的指标，可忠实地反映急性失代偿期 HF 的充血体征和临床状态。
