膈神经刺激治疗心力衰竭患者中枢性睡眠呼吸暂停。
Phrenic nerve stimulation for the treatment of central sleep apnea in patients with heart failure.
机构信息
Sleep Medicine Center, Charité-Universitätsmedizin, Charitéplatz 1, 10117, Berlin, Germany.
Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
出版信息
Sleep Breath. 2023 Jun;27(3):1027-1032. doi: 10.1007/s11325-022-02699-8. Epub 2022 Aug 17.
OBJECTIVE
Central sleep apnea (CSA) is associated with increased morbidity and mortality in patients with heart failure (HF). We aimed to explore the effectiveness of phrenic nerve stimulation (PNS) on CSA in patients with HF.
METHODS
This was a prospective and non-randomized study. The stimulation lead was inserted into the right brachiocephalic vein and attached to a proprietary neurostimulator. Monitoring was conducted during the implantation process, and all individuals underwent two-night polysomnography.
RESULTS
A total of nine subjects with HF and CSA were enrolled in our center. There was a significant decrease in the apnea-hypopnea index (41 ± 18 vs 29 ± 25, p = 0.02) and an increase in mean arterial oxygen saturation (SaO2) (93% ± 1% vs 95% ± 2%, p = 0.03) after PNS treatment. We did not observe any significant differences of oxygen desaturation index (ODI) and SaO2 < 90% (T90) following PNS. Unilateral phrenic nerve stimulation might also categorically improve the severity of sleep apnea.
CONCLUSION
In our non-randomized study, PNS may serve as a therapeutic approach for CSA in patients with HF.
目的
中枢性睡眠呼吸暂停（CSA）与心力衰竭（HF）患者的发病率和死亡率增加有关。我们旨在探讨膈神经刺激（PNS）对 HF 患者 CSA 的疗效。
方法
这是一项前瞻性、非随机研究。刺激导线被插入右头臂静脉并连接到专有的神经刺激器。在植入过程中进行监测，所有患者均进行了两晚的多导睡眠图检查。
结果
我们中心共纳入了 9 名 HF 合并 CSA 的患者。PNS 治疗后，呼吸暂停-低通气指数（41±18 比 29±25，p=0.02）显著降低，平均动脉血氧饱和度（SaO2）（93%±1%比 95%±2%，p=0.03）升高。我们没有观察到 PNS 后氧减指数（ODI）和 SaO2<90%（T90）有任何显著差异。单侧膈神经刺激也可能明确改善睡眠呼吸暂停的严重程度。
结论
在我们的非随机研究中，PNS 可能是 HF 患者 CSA 的一种治疗方法。
Zotero 插件