Coniglio Amanda C, Mentz Robert J
Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Duke Clinical Research Institute, PO Box 17969, Durham, NC 27715, USA.
Cardiol Clin. 2022 May;40(2):183-189. doi: 10.1016/j.ccl.2021.12.006.
Sleep-disordered breathing (SDB), including obstructive sleep apnea, central sleep apnea (CSA), and Cheyne-Stokes respiration, is common in patients with heart failure (HF) and associated with lower left ventricular ejection fraction (EF), increased arrhythmia burden, and increased mortality. Continuous positive airway pressure therapy improves short-term and long-term outcomes in HF patients. Adaptive servoventilation (ASV) therapy in patients with low-EF HF with predominant CSA is not recommended. Ongoing trials are evaluating whether ASV will have a role in SDB treatment. Phrenic nerve stimulation is an emerging treatment option that has shown promising outcomes. All HF patients should be screened for SDB.
睡眠呼吸障碍(SDB),包括阻塞性睡眠呼吸暂停、中枢性睡眠呼吸暂停(CSA)和潮式呼吸,在心力衰竭(HF)患者中很常见,并且与较低的左心室射血分数(EF)、心律失常负担增加和死亡率增加相关。持续气道正压通气治疗可改善HF患者的短期和长期预后。不建议对以CSA为主的低EF HF患者进行适应性伺服通气(ASV)治疗。正在进行的试验正在评估ASV是否会在SDB治疗中发挥作用。膈神经刺激是一种新兴的治疗选择,已显示出有前景的结果。所有HF患者均应筛查SDB。