睡眠片段化与充血性心力衰竭的发病率：睡眠心脏健康研究
Sleep fragmentation and incidence of congestive heart failure: the Sleep Heart Health Study.
作者信息
Yan Bin, Wu Yanhua, Fan Xiaojuan, Lu Qun, Ma Xiancang, Bai Ling
机构信息
Department of Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Department of Cardiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
出版信息
J Clin Sleep Med. 2021 Aug 1;17(8):1619-1625. doi: 10.5664/jcsm.9270.
STUDY OBJECTIVES
Sleep fragmentation (SF) has been reported to be associated with cardiovascular risk. The aim of this study was to explore the relationship between SF and congestive heart failure (CHF).
METHODS
A total of 4,887 participants (2,256 males and 2,631 females; mean age of 63.6 ± 11.0 years) from the Sleep Heart Health Study were included in this study. Incident CHF was defined as the first occurrence of CHF between baseline in-home polysomnography (PSG) and the end of follow-up. Objective assessments for SF, including sleep fragmentation index (SFI), arousal index (ArI), sleep efficiency (SE), and wake after sleep onset (WASO), were determined based on in-home PSG records. Multivariate Cox regression analysis was used to investigate the relationship between SF and incident CHF.
RESULTS
During an average of 10 years of follow-up, 543 participants with CHF (11.1%) were observed. Individuals with CHF had a significantly higher SFI, total ArI, and WASO and a lower SE than controls. After multivariate Cox regression analysis, SE (odds ratio [OR], 0.967; 95% confidence interval [CI], 0.955-0.978; < .001), WASO (OR, 1.009; 95% CI, 1.006-1.012; < .001), SFI (OR, 1.046; 95% CI, 1.007-1.086; = .021), and total ArI (OR, 1.018; 95% CI, 1.000-1.035; = .044) were found to be associated with the incidence of CHF in participants without hypertension.
CONCLUSIONS
Objectively measured SF was associated with the incidence of CHF. The role of SFI, total ArI, SE, and WASO deserves further investigation.
CLINICAL TRIAL REGISTRATION
Registry: ClinicalTrials.gov; Name: Sleep Heart Health Study (SHHS) Data Coordinating Center (SHHS); URL: https://clinicaltrials.gov/ct2/show/NCT00005275; Identifier: NCT00005275.
CITATION
Yan B, Wu Y, Fan X, Lu Q, Ma X, Bai L. Sleep fragmentation and incidence of congestive heart failure: the Sleep Heart Health Study. . 2021;17(8):1619-1625.
研究目的
据报道，睡眠片段化（SF）与心血管风险相关。本研究旨在探讨SF与充血性心力衰竭（CHF）之间的关系。
方法
本研究纳入了睡眠心脏健康研究中的4887名参与者（男性2256名，女性2631名；平均年龄63.6±11.0岁）。新发CHF定义为在家中进行基线多导睡眠图（PSG）检查至随访结束期间首次发生的CHF。基于家中PSG记录确定SF的客观评估指标，包括睡眠片段化指数（SFI）、觉醒指数（ArI）、睡眠效率（SE）和睡眠开始后觉醒时间（WASO）。采用多变量Cox回归分析来研究SF与新发CHF之间的关系。
结果
在平均10年的随访期间，观察到543名参与者发生CHF（11.1%）。CHF患者的SFI、总ArI和WASO显著高于对照组，而SE低于对照组。多变量Cox回归分析后发现，在无高血压的参与者中，SE（比值比[OR]，0.967；95%置信区间[CI]，0.955 - 0.978；P <.001）、WASO（OR，1.009；95% CI，1.006 - 1.012；P <.001）、SFI（OR，1.046；95% CI，1.007 - 1.086；P = 0.021）和总ArI（OR，1.018；95% CI，1.000 - 1.035；P = 0.044）与CHF的发生率相关。
结论
客观测量的SF与CHF的发生率相关。SFI、总ArI、SE和WASO的作用值得进一步研究。
临床试验注册
注册机构：ClinicalTrials.gov；名称：睡眠心脏健康研究（SHHS）数据协调中心（SHHS）；网址：https://clinicaltrials.gov/ct2/show/NCT00005275；标识符：NCT00005275。
引用
Yan B, Wu Y, Fan X, Lu Q, Ma X, Bai L. Sleep fragmentation and incidence of congestive heart failure: the Sleep Heart Health Study. . 2021;17(8):1619 - 1625.
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