心力衰竭不同病因患者的睡眠呼吸障碍。
Sleep-disordered breathing in heart failure patients with different etiologies.
机构信息
Department of Cardiology, Zhongda Hospital, School of medicine, Southeast University, Nanjing, China.
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
出版信息
Clin Cardiol. 2022 Jul;45(7):778-785. doi: 10.1002/clc.23840. Epub 2022 May 10.
BACKGROUND
The prevalence of sleep-disordered breathing (SDB) is closely related to the severity of heart failure (HF), and the severity of HF is different in patients with HF of different etiologies.
HYPOTHESIS
This study aimed to explore the prevalence of SDB in patients with HFof different etiologies.
METHODS
Hospitalized HF patients were consecutively enrolled. All patients underwent portable overnight cardiorespiratory polygraphy. Patients were divided into five groups according to the etiology of HF: ischemic, hypertensive, myocardial, valvular, and arrhythmic. The prevalence of SDB and clinical data was compared among the five groups.
RESULTS
In total, 248 patients were enrolled in this study. The prevalence of SDB in HF was 70.6%, with the prevalence of obstructive sleep apnea (OSA) at 47.6% and central sleep apnea (CSA) at 23.0%. Patients were divided into five groups: ischemic, hypertensive, myocardial, valvular, and arrhythmic. The prevalence of SDB among the five groups was 75.3%, 81.4%, 77.8%, 51.9%, and 58.5% (p = .014), respectively. The prevalence of OSA among the five groups was 42.7%, 72.1%, 36.1%, 37.0%, and 49.1% (p = .009), whereas the CSA was 32.6%, 9.3%, 41.7%, 14.8%, and 9.4% (p < .001), respectively.
CONCLUSIONS
SDB is common in HF patients. The prevalence and types of SDB varied in HF with different etiologies, which may be related to the different severities of HF. SDB was highly prevalent in patients with ischemic, hypertensive, and myocardial HF. Hypertensive HF patients were mainly complicated with OSA, while myocardial HF patients were mainly complicated with CSA. Both conditions were highly prevalent in ischemic HF patients. The prevalence of SDB was relatively low in valvular and arrhythmic HF patients, and OSA was the main type.
背景
睡眠呼吸障碍（SDB）的患病率与心力衰竭（HF）的严重程度密切相关，不同病因的 HF 患者的 HF 严重程度也不同。
假设
本研究旨在探讨不同病因 HF 患者 SDB 的患病率。
方法
连续纳入住院 HF 患者。所有患者均接受便携式夜间心肺多导图检查。根据 HF 的病因将患者分为五组：缺血性、高血压性、心肌性、瓣膜性和心律失常性。比较五组间 SDB 及临床资料的患病率。
结果
共纳入 248 例患者。HF 患者 SDB 的患病率为 70.6%，其中阻塞性睡眠呼吸暂停（OSA）患病率为 47.6%，中枢性睡眠呼吸暂停（CSA）患病率为 23.0%。患者分为五组：缺血性、高血压性、心肌性、瓣膜性和心律失常性。五组 SDB 的患病率分别为 75.3%、81.4%、77.8%、51.9%和 58.5%（p=0.014）。五组 OSA 的患病率分别为 42.7%、72.1%、36.1%、37.0%和 49.1%（p=0.009），CSA 分别为 32.6%、9.3%、41.7%、14.8%和 9.4%（p<0.001）。
结论
SDB 在 HF 患者中很常见。不同病因 HF 患者 SDB 的患病率和类型不同，这可能与 HF 的严重程度不同有关。缺血性、高血压性和心肌性 HF 患者 SDB 患病率较高。高血压性 HF 患者主要合并 OSA，而心肌性 HF 患者主要合并 CSA。这两种情况在缺血性 HF 患者中均很常见。瓣膜性和心律失常性 HF 患者 SDB 的患病率相对较低，主要类型为 OSA。
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