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心力衰竭加重且超重患者的睡眠呼吸暂停

Sleep apnea in patients with exacerbated heart failure and overweight.

作者信息

Kalaydzhiev Petar, Poroyliev Nikolay, Somleva Desislava, Ilieva Radostina, Markov Dimitar, Kinova Elena, Goudev Asen

机构信息

Medical University, Sofia, Bulgaria.

University Hospital "Tsaritsa Yoanna - ISUL", Byalo More St Ν8, Clinical of Cardiology, Sofia, Bulgaria.

出版信息

Sleep Med X. 2023 Feb 28;5:100065. doi: 10.1016/j.sleepx.2023.100065. eCollection 2023 Dec.

Abstract

Sleep disorders are a common concomitant comorbidity in patients with heart failure. The aims of our study are to determine the incidence and phenotypic characteristics of sleep apnea in overweight patients with exacerbated heart failure and to assess the degree of involvement of systolic and diastolic function impairment in the individual group. From 100 screened patients with heart failure in our department from 2015 to 2017, 61 met the inclusion criteria and participated in the study. 82% (n = 50) of the patients had obstructive sleep apnea (OSA), and 18% (n = 11) had central sleep apnea (CSA). The CSA group had a significantly lower left ventricular ejection fraction (LVEF) than the OSA group (EF% 49.6 ± 8.5 vs 41.8 ± 11.4; p = 0.013). A negative correlation was found between LVEF and the number of central apnea events (r = -0.52; p < 0.001). More frequent hospitalizations for heart failure (HF) and higher mortality rate were found in the CSA group. Screening for sleep apnea in patients with exacerbated heart failure and obesity is necessary for the complex treatment of these patients.

摘要

睡眠障碍是心力衰竭患者常见的合并症。我们研究的目的是确定超重且心力衰竭加重患者睡眠呼吸暂停的发生率和表型特征,并评估各个组中收缩和舒张功能损害的受累程度。在2015年至2017年期间,我们科室对100例筛查出的心力衰竭患者进行研究,其中61例符合纳入标准并参与了研究。82%(n = 50)的患者患有阻塞性睡眠呼吸暂停(OSA),18%(n = 11)的患者患有中枢性睡眠呼吸暂停(CSA)。CSA组的左心室射血分数(LVEF)明显低于OSA组(EF% 49.6 ± 8.5 vs 41.8 ± 11.4;p = 0.013)。LVEF与中枢性呼吸暂停事件数量之间存在负相关(r = -0.52;p < 0.001)。CSA组心力衰竭(HF)住院频率更高,死亡率也更高。对心力衰竭加重且肥胖的患者进行睡眠呼吸暂停筛查对于这些患者的综合治疗是必要的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a15d/10009711/8208288ee198/gr1.jpg

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