Department of Internal Medicine II - Cardiology, Pneumology, Angiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
Department of Pediatric Cardiology, University Hospital Bonn, Bonn, Germany.
Sleep Breath. 2024 Mar;28(1):241-250. doi: 10.1007/s11325-023-02899-w. Epub 2023 Aug 8.
Advances in treatment enables most patients with congenital heart diseases (CHD) to survive into adulthood, implying the need to address comorbid conditions in this growing cohort of patients. The aim of this study was to evaluate the prevalence of sleep-disordered breathing (SDB) and lung function abnormalities in patients with adult congenital heart disease (ACHD).
Patients with ACHD underwent level 3 sleep testing (Embletta MPR polygraphy) and pulmonary function testing. Results were stratified by the underlying haemodynamic ACHD lesion group.
Patients with ACHD (n = 100) were middle-aged (42.3 ± 14.6 years), 54% male and slightly overweight (BMI 25.9 ± 5.5 kg/m). Polygraphy revealed a prevalence of sleep apnoea of 39% with 15% of patients presenting with predominantly obstructive apnoeic episodes, while 23% of patients presenting primarily with central sleep apnoea. The distribution of mild, moderate, and severe sleep apnoea in the total study population was 26%, 7% and 6%, respectively. Comparison of apnoea-hypopnoea index, presence of sleep apnoea, and apnoea severity did not offer significant differences between the four ACHD lesion groups (p = 0.29, p = 0.41 and p = 0.18, respectively). Pulmonary function testing revealed obstructive lung disease in 19 of 100 patients. Concomitant chronic obstructive pulmonary disease and obstructive sleep apnoea were diagnosed in 3% of patients and were associated with profound nocturnal desaturation.
The findings suggest a mild propensity amongst patients with ACHD to develop SDB that seems to be unaffected by the specific underlying congenital lesion.
治疗的进步使大多数先天性心脏病 (CHD) 患者能够存活到成年，这意味着需要解决这一不断增长的患者群体中的合并症。本研究旨在评估成人先天性心脏病 (ACHD) 患者睡眠呼吸障碍 (SDB) 和肺功能异常的患病率。
ACHD 患者接受三级睡眠测试（Embletta MPR 多导睡眠图）和肺功能测试。结果按基础血流动力学 ACHD 病变组进行分层。
ACHD 患者（n=100）年龄中位数为 42.3±14.6 岁，54%为男性，体重略超重（BMI 25.9±5.5kg/m）。多导睡眠图显示睡眠呼吸暂停的患病率为 39%，其中 15%的患者表现为以阻塞性呼吸暂停为主，而 23%的患者主要表现为中枢性睡眠呼吸暂停。在总研究人群中，轻度、中度和重度睡眠呼吸暂停的分布分别为 26%、7%和 6%。在四个 ACHD 病变组之间，呼吸暂停-低通气指数、睡眠呼吸暂停的存在和呼吸暂停的严重程度比较没有显著差异（p=0.29、p=0.41 和 p=0.18，分别）。肺功能测试显示 100 名患者中有 19 名患有阻塞性肺疾病。3%的患者同时诊断出慢性阻塞性肺病和阻塞性睡眠呼吸暂停，与严重的夜间低氧血症有关。
这些发现表明 ACHD 患者存在轻微的 SDB 倾向，似乎不受特定的先天性病变的影响。
