Naito Ryo, Kasai Takatoshi, Narui Koji, Momomura Shin-Ichi
Department of Cardiovascular Biology and Medicine, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan.
Cardiovascular Respiratory Sleep Medicine, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan.
J Clin Med. 2022 Apr 25;11(9):2403. doi: 10.3390/jcm11092403.
Heart failure (HF) is a progressive cardiac disorder associated with high mortality and morbidity. Previous studies have shown that sleep apnea (SA) is associated with a poor prognosis in HF patients. When HF coexists with SA, both central and obstructive respiratory events often occur. However, few studies have investigated the association between the frequency of central respiratory events coexisting with obstructive events and clinical outcomes in patients with HF and SA. This was a retrospective observational study. Patients with stable HF, defined as a left ventricular ejection fraction of ≤50%, New York Heart Association class ≥ II, and SA (apnea-hypopnea index of ≥15/h on overnight polysomnography) were enrolled. The primary endpoint was a composite of all-cause death and hospitalization for HF. Overall, 144 patients were enrolled. During a period of 23.4 ± 16 months, 45.8% of patients experienced the outcome. The cumulative event-free survival rates were higher in the central SA-predominant group. Multivariate analyses showed that a greater percentage of central respiratory events was associated with an increased risk of clinical outcomes. In patients with HF and SA, the frequency of central respiratory events was an independent factor for all-cause death and hospitalization for HF.
心力衰竭（HF）是一种与高死亡率和高发病率相关的进行性心脏疾病。先前的研究表明，睡眠呼吸暂停（SA）与HF患者的不良预后相关。当HF与SA共存时，中枢性和阻塞性呼吸事件常常都会发生。然而，很少有研究调查HF合并SA患者中，中枢性呼吸事件与阻塞性事件并存的频率与临床结局之间的关联。这是一项回顾性观察研究。纳入了稳定HF患者，定义为左心室射血分数≤50%、纽约心脏协会分级≥II级，以及SA患者（夜间多导睡眠图显示呼吸暂停低通气指数≥15次/小时）。主要终点是全因死亡和HF住院的复合终点。总体而言，共纳入了144例患者。在23.4±16个月的时间段内，45.8%的患者出现了该结局。以中枢性SA为主的组累积无事件生存率更高。多变量分析显示，中枢性呼吸事件的比例更高与临床结局风险增加相关。在HF合并SA的患者中，中枢性呼吸事件的频率是全因死亡和HF住院的独立因素。
