Am J Respir Crit Care Med. 2021 Mar 15;203(6):e11-e24. doi: 10.1164/rccm.202101-0190ST.
Central sleep apnea (CSA) is common among patients with heart failure and has been strongly linked to adverse outcomes. However, progress toward improving outcomes for such patients has been limited. The purpose of this official statement from the American Thoracic Society is to identify key areas to prioritize for future research regarding CSA in heart failure. An international multidisciplinary group with expertise in sleep medicine, pulmonary medicine, heart failure, clinical research, and health outcomes was convened. The group met at the American Thoracic Society 2019 International Conference to determine research priority areas. A statement summarizing the findings of the group was subsequently authored using input from all members.: The workgroup identified 11 specific research priorities in several key areas: ) control of breathing and pathophysiology leading to CSA, ) variability across individuals and over time, ) techniques to examine CSA pathogenesis and outcomes, ) impact of device and pharmacological treatment, and ) implementing CSA treatment for all individuals Advancing care for patients with CSA in the context of heart failure will require progress in the arenas of translational (basic through clinical), epidemiological, and patient-centered outcome research. Given the increasing prevalence of heart failure and its associated substantial burden to individuals, society, and the healthcare system, targeted research to improve knowledge of CSA pathogenesis and treatment is a priority.
中枢性睡眠呼吸暂停(CSA)在心力衰竭患者中较为常见,与不良结局密切相关。然而,此类患者的治疗进展一直较为有限。美国胸科学会(ATS)发布本官方声明旨在确定心力衰竭患者 CSA 相关研究的重点优先领域。一个在睡眠医学、肺病学、心力衰竭、临床研究和健康结果等领域具有专业知识的国际多学科小组应邀参与。该小组在 2019 年美国胸科学会国际会议上进行了会面,以确定研究优先领域。随后,所有小组成员共同参与,使用该会议上获得的信息,起草了一份总结小组研究结果的声明。工作组在以下几个关键领域确定了 11 项具体的研究重点:)呼吸控制和导致 CSA 的病理生理学,)个体间和随时间的变异性,)检查 CSA 发病机制和结局的技术,)设备和药物治疗的影响,以及)为所有个体实施 CSA 治疗。要在心力衰竭的背景下为 CSA 患者提供更优质的医疗服务,就需要在转化(基础到临床)、流行病学和以患者为中心的结局研究领域取得进展。鉴于心力衰竭的发病率不断上升,对个人、社会和医疗体系造成的负担也相当沉重,有针对性地开展 CSA 发病机制和治疗的研究,是当务之急。