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接受肺静脉隔离术的心房颤动患者睡眠呼吸障碍与陈-施呼吸的相关因素

Correlates of sleep-disordered breathing and Cheyne-Stokes respiration in patients with atrial fibrillation who have undergone pulmonary vein isolation.

作者信息

Sato Akihiro, Matsumoto Hiroki, Kasai Takatoshi, Shiroshita Nanako, Ishiwata Sayaki, Yatsu Shoichiro, Shitara Jun, Murata Azusa, Kato Takao, Suda Shoko, Hiki Masaru, Naito Ryo, Tabuchi Haruna, Miyazaki Sakiko, Hayashi Hidemori, Daida Hiroyuki, Minamino Tohru

机构信息

Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.

Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

出版信息

Heart Vessels. 2025 Feb;40(2):140-148. doi: 10.1007/s00380-024-02449-8. Epub 2024 Sep 4.

DOI:10.1007/s00380-024-02449-8
PMID:39227419
Abstract

Sleep disordered breathing (SDB) is a common comorbidity in patients with atrial fibrillation (AF). Patients undergoing pulmonary vein isolation (PVI) for AF have a high prevalence of SDB. In previous studies, some patients with AF had Cheyne-Stokes respiration (CSR). The aim of the present study was to assess the prevalence of SDB and the correlates of SDB severity and CSR in AF patients who have undergone PVI. The study was conducted using a single-center observational design. All participants underwent a home sleep apnea test (ApneaLink Air, ResMed, Australia), which could determine the severity of SDB as assessed by the apnea-hypopnea index (AHI) and the percentage of CSR (%CSR) pattern. 139 AF patients who underwent PVI were included in the study. Overall, 38 (27.3%) patients had no SDB (AHI < 5), 53 (38.1%) had mild SDB (5 ≤ AHI < 15), 33 (23.7%) had moderate SDB (15 ≤ AHI < 30), and 15 (10.8%) had severe SDB (AHI ≥ 30). Correlates of the increased AHI included male sex (β = 0.23, p = 0.004), age (β = 0.19, p = 0.020), high body mass index (β = 0.31, p < 0.001), and β blockers usage (β = 0.18, p = 0.024). Conversely, correlates with the %CSR rate included male sex (β = 0.18, p = 0.020), age (β = 0.19, p = 0.015), non-paroxysmal AF (β = 0.22, p = 0.008), and high glycohemoglobin A1c (β = 0.36, p < 0.001) and N-terminal pro-brain natriuretic peptide (β = 0.24, p = 0.005) levels. SDB is prevalent in patients with AF who have undergone PVI; predisposing factors for SDB include male sex, older age, and obesity. CSR occurs in patients with AF who have undergone PVI; predisposing factors for CSR include male sex, older age, high left ventricular filling pressure, and abnormal blood glucose level.

摘要

睡眠呼吸障碍(SDB)是心房颤动(AF)患者中常见的合并症。接受肺静脉隔离(PVI)治疗AF的患者中SDB的患病率很高。在先前的研究中,一些AF患者出现了潮式呼吸(CSR)。本研究的目的是评估接受PVI治疗的AF患者中SDB的患病率以及SDB严重程度和CSR的相关因素。该研究采用单中心观察性设计。所有参与者均接受了家庭睡眠呼吸暂停测试(ApneaLink Air,瑞思迈公司,澳大利亚),该测试可以通过呼吸暂停低通气指数(AHI)和CSR模式百分比(%CSR)来确定SDB的严重程度。139例接受PVI治疗的AF患者被纳入研究。总体而言,38例(27.3%)患者无SDB(AHI<5),53例(38.1%)患者有轻度SDB(5≤AHI<15),33例(23.7%)患者有中度SDB(15≤AHI<30),15例(10.8%)患者有重度SDB(AHI≥30)。AHI升高的相关因素包括男性(β=0.23,p=0.004)、年龄(β=0.19,p=0.020)、高体重指数(β=0.31,p<0.001)和使用β受体阻滞剂(β=0.18,p=0.024)。相反,与%CSR率相关的因素包括男性(β=0.18,p=0.020)、年龄(β=0.19,p=0.015)、非阵发性AF(β=0.22,p=0.008)以及高糖化血红蛋白A1c(β=0.

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本文引用的文献

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Screening for Sleep Apnea in Atrial Fibrillation Prior to Catheter Ablation.导管消融术前心房颤动患者睡眠呼吸暂停的筛查
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Central sleep apnea and atrial fibrillation: A review on pathophysiological mechanisms and therapeutic implications.
中枢性睡眠呼吸暂停与心房颤动:病理生理机制及治疗意义综述
Int J Cardiol Heart Vasc. 2020 May 22;30:100527. doi: 10.1016/j.ijcha.2020.100527. eCollection 2020 Oct.
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