Wakabayashi Yasushi, Koyama Takashi, Kurihara Kazuto, Kobayashi Masanori, Ichikawa Tomohide, Abe Hidetoshi
Department of Cardiovascular Medicine, Matsumoto Kyoritsu Hospital, 9-26 Habaue, Matsumoto City, Nagano, 390-8505, Japan.
Heart Vessels. 2020 Jun;35(6):817-824. doi: 10.1007/s00380-019-01551-6. Epub 2020 Jan 2.
Previous studies suggested that sleep-disordered breathing was associated with cardiovascular diseases such as heart failure (HF). Recently, algorithms of cardiac implantable electronic devices (CIEDs) have been developed to detect advanced sleep apnea (SA); the Apnea Scan (AP Scan) being an example. The purpose of this study was to investigate the association between respiratory disturbance index (RDI) measured using the AP Scan algorithm and HF development. We retrospectively studied consecutive patients with CIEDs equipped with the AP Scan algorithm which were implanted between December 1, 2011 and March 31, 2019. These patients were divided into 2 groups according to the trends of RDI: patients with a continually high RDI > 30 (severe SA group) and those without a continually high RDI (non-severe SA group). There were 16 and 46 patients in the severe and non-severe SA groups, respectively. Increased left ventricular end-diastolic and end-systolic dimensions were observed in the severe SA group. Regarding cardiovascular events, HF was observed in 8 patients (50.0%) in the severe SA group and 1 patient (2.2%) in the non-severe SA group; thus, there was a significantly higher proportion of patients with HF in the severe SA group. In conclusion, continually high RDI was associated with HF development in patients with CIEDs equipped with the AP Scan algorithm. Therefore, an elevated RDI may be a risk factor for the development of HF in patients with CIEDs.
先前的研究表明,睡眠呼吸紊乱与心力衰竭(HF)等心血管疾病有关。最近,已开发出心脏植入式电子设备(CIED)算法来检测晚期睡眠呼吸暂停(SA);Apnea Scan(AP Scan)就是一个例子。本研究的目的是调查使用AP Scan算法测量的呼吸紊乱指数(RDI)与HF发生之间的关联。我们回顾性研究了2011年12月1日至2019年3月31日期间植入了配备AP Scan算法的CIED的连续患者。根据RDI的趋势将这些患者分为两组:RDI持续高于30的患者(严重SA组)和RDI未持续升高的患者(非严重SA组)。严重SA组和非严重SA组分别有16例和46例患者。严重SA组观察到左心室舒张末期和收缩末期尺寸增加。关于心血管事件,严重SA组有8例患者(50.0%)发生HF,非严重SA组有1例患者(2.2%)发生HF;因此,严重SA组中发生HF的患者比例明显更高。总之,在配备AP Scan算法的CIED患者中,持续高RDI与HF发生有关。因此,RDI升高可能是CIED患者发生HF的一个危险因素。