心力衰竭患者中枢性睡眠呼吸暂停的评估与治疗。

Evaluation and Treatment of Central Sleep Apnea in Patients with Heart Failure.

机构信息

Department of Medicine, Duke University Medical Center, Durham, NC, USA; Duke Clinical Research Institute, Durham, NC, USA.

Department of Medicine, Ziauddin Medical University, Karachi, Pakistan.

出版信息

Curr Probl Cardiol. 2022 Dec;47(12):101364. doi: 10.1016/j.cpcardiol.2022.101364. Epub 2022 Aug 19.

DOI:10.1016/j.cpcardiol.2022.101364

PMID:35995244

Abstract

Sleep-disordered breathing (SDB) is a common comorbidity in patients with heart failure (HF). Prevalence of the most common subtypes of SDB, central sleep apnea (CSA) and obstructive sleep apnea (OSA), is increasing, which is concerning due to the association of SDB with increased mortality in patients with HF. Despite an increasing burden of CSA in HF, it is difficult to detect using current diagnostic tools and the treatment modalities are limited by variable efficacy and patient adherence. Though positive airway pressure therapies remain the cornerstone of OSA treatment, the management of CSA in the setting of HF continues to evolve. The association of the presence of CSA with worse prognosis in HF patients warrants the need for routine screening for signs and symptoms of CSA in this population. In this review, we examine the connection between CSA and HF, and highlight advancements in timely diagnostics, treatment modalities, and strategies to promote facilitation of compliance in this high-risk cohort.

摘要

睡眠障碍性呼吸（SDB）是心力衰竭（HF）患者的常见合并症。最常见的 SDB 亚型，中枢性睡眠呼吸暂停（CSA）和阻塞性睡眠呼吸暂停（OSA）的患病率正在增加，这令人担忧，因为 SDB 与 HF 患者的死亡率增加有关。尽管 CSA 在 HF 中的负担不断增加，但使用当前的诊断工具很难检测到，并且治疗方式受到疗效和患者依从性的差异的限制。尽管正压通气疗法仍然是 OSA 治疗的基石，但 HF 中 CSA 的治疗仍在不断发展。CSA 的存在与 HF 患者预后恶化之间的关联证明了在该人群中常规筛查 CSA 体征和症状的必要性。在这篇综述中，我们研究了 CSA 与 HF 之间的联系，并强调了在这个高危人群中及时诊断、治疗方式和促进依从性的策略的进步。