Javaheri Shahrokh, Javaheri Sogol
Division of Pulmonary and Sleep Medicine, Bethesda North Hospital, Cincinnati, OH 45242, USA.
Division of Cardiology, The Ohio State University, Columbus, OH 43210, USA.
J Clin Med. 2022 Jun 16;11(12):3458. doi: 10.3390/jcm11123458.
Obstructive sleep apnea (OSA) is highly prevalent among patients with asymptomatic left ventricular systolic and diastolic dysfunction and congestive heart failure, and if untreated may contribute to the clinical progression of heart failure (HF). Given the health and economic burden of HF, identifying potential modifiable risk factors such as OSA and whether appropriate treatment improves outcomes is of critical importance. Identifying the subgroups of patients with OSA and HF who would benefit most from OSA treatment is another important point. This focused review surveys current knowledge of OSA and HF in order to provide: (1) a better understanding of the pathophysiologic mechanisms that may increase morbidity among individuals with HF and comorbid OSA, (2) a summary of current observational data and small randomized trials, (3) an understanding of the limitations of current larger randomized controlled trials, and (4) future needs to more accurately determine the efficacy of OSA treatment among individuals with HF.
阻塞性睡眠呼吸暂停（OSA）在无症状左心室收缩和舒张功能障碍以及充血性心力衰竭患者中非常普遍，如果不进行治疗，可能会导致心力衰竭（HF）的临床进展。鉴于HF对健康和经济造成的负担，识别潜在的可改变风险因素（如OSA）以及适当的治疗是否能改善预后至关重要。确定OSA和HF患者中最能从OSA治疗中获益的亚组是另一个要点。本重点综述调查了目前关于OSA和HF的知识，以便：（1）更好地理解可能增加HF合并OSA个体发病率的病理生理机制，（2）总结当前的观察性数据和小型随机试验，（3）了解当前大型随机对照试验的局限性，以及（4）未来更准确确定OSA治疗对HF个体疗效的需求。
