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通过心肺多导描记术测量的不同类型心脏病患者肺至指循环时间的变化。

Changes in lung to finger circulation time measured via cardiopulmonary polygraphy in patients with varying types of heart disease.

机构信息

Department of Cardiovascular Medicine, Saiseikai Futsukaichi Hospital, Chikushino, Japan.

Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan.

出版信息

Heart Vessels. 2021 Jan;36(1):58-68. doi: 10.1007/s00380-020-01657-2. Epub 2020 Jul 1.

Abstract

Cardiopulmonary polygraphy (PG) demonstrates not only parameters for sleep disordered breathing (SDB) but also hemodynamics. We previously developed a software that detects lung to fingertip circulation time (LFCT) derived from PG dataset and reported that those LFCT reflected the cardiac output. The purpose of this study is to investigate how the LFCT changes during clinical course and whether reflects the impact of in-hospital treatment on cardiac function. Consecutive patients (N = 89) who admitted to the cardiovascular division, underwent PG at the early and late phase of admission. Parameters for SDB and LFCT were compared between an acute decompensated heart failure (ADHF) group (n = 51) and non-ADHF group (n = 38). ADHF group was further divided into subgroups: preserved ejection fraction (pEF) (EF > 40%) and reduced EF (rEF) (EF ≤ 40%). Using our original algorithm, we obtained LFCT values from all of the patients, though 29.4% of ADHF and 44.7% of non-ADHF had no or mild SDB. LFCT significantly shortened in the ADHF-rEF group, in contrast to ADHF-pEF group or non-ADHF group (ADHF-rEF group: 26.9 ± 7.6 to 24.2 ± 6.1 s, p = 0.01; ADHF-pEF group: 25.3 ± 7.3 to 25.3 ± 6.9 s, p = 0.98; non-ADHF group: 21.5 ± 5.5 to 21.9 ± 5.0 s, p = 0.65). The respiratory disorder index in the ADHF group improved after treatment, irrespective of EF (pEF: 26.9 ± 16.1 to 15.8 ± 11.9/h, p < 0.01; rEF: 27.0 ± 16.5 to 20.7 ± 13.6/h, p = 0.03). Automatic detection of LFCT was feasible in almost all cardiac patients. LFCT value changed according to the heart failure treatment in ADHF-rEF patients and reflected cardiac function. LFCT might be a useful indicator of effective cardiac disease treatment.

摘要

心肺多导描记术(PG)不仅可以显示睡眠呼吸障碍(SDB)的参数,还可以显示血液动力学参数。我们之前开发了一种从 PG 数据集中检测到肺到指尖循环时间(LFCT)的软件,并报告说这些 LFCT 反映了心输出量。本研究的目的是探讨 LFCT 在临床病程中的变化,以及是否反映了住院治疗对心脏功能的影响。连续患者(N=89)被收入心血管科,在入院的早期和晚期进行 PG。比较急性失代偿性心力衰竭(ADHF)组(n=51)和非 ADHF 组(n=38)之间的 SDB 和 LFCT 参数。ADHF 组进一步分为射血分数保留(pEF)(EF>40%)和射血分数降低(rEF)(EF≤40%)亚组。使用我们的原始算法,我们从所有患者中获得了 LFCT 值,尽管 29.4%的 ADHF 和 44.7%的非 ADHF 患者没有或仅有轻度 SDB。与 ADHF-pEF 组或非 ADHF 组相比,ADHF-rEF 组的 LFCT 明显缩短(ADHF-rEF 组:26.9±7.6 至 24.2±6.1 s,p=0.01;ADHF-pEF 组:25.3±7.3 至 25.3±6.9 s,p=0.98;非 ADHF 组:21.5±5.5 至 21.9±5.0 s,p=0.65)。ADHF 组的呼吸障碍指数在治疗后得到改善,与 EF 无关(pEF:26.9±16.1 至 15.8±11.9/h,p<0.01;rEF:27.0±16.5 至 20.7±13.6/h,p=0.03)。几乎所有心脏患者都可以进行 LFCT 的自动检测。ADHF-rEF 患者的心力衰竭治疗后 LFCT 值发生变化,反映了心脏功能。LFCT 可能是评估心脏疾病治疗效果的有用指标。

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