Kalaydzhiev Petar, Borizanova Angelina, Georgieva Neli, Voynova Gergana, Yakov Slavi, Kocev Tsvetan, Tomova-Lyutakova Galya, Krastev Bozhidar, Spasova Natalia, Ilieva Radostina, Kinova Elena, Goudev Assen
Department of Emergency Medicine, Medical University-Sofia, 1000 Sofia, Bulgaria.
Cardiology Department, University Hospital "Tsaritsa Yoanna-ISUL", 1000 Sofia, Bulgaria.
J Clin Med. 2024 Sep 24;13(19):5676. doi: 10.3390/jcm13195676.
: Acute decompensated heart failure (ADHF) is a condition with a high frequency of hospitalizations and mortality, and obstructive sleep apnea (OSA) is a common comorbidity. Continuous positive airway pressure (CPAP) therapy at home can be a good adjunctive non-drug therapy for these patients. : We conducted a single-center, prospective cohort study from 150 consecutive patients hospitalized for heart failure exacerbation in the cardiology department. Of these, 57 patients had obstructive sleep apnea. After discharge, CPAP therapy at home was offered. We divided them into two groups and followed them for 1 year. All patients received optimal medical treatment. At the end of the period, patients underwent a follow-up physical examination, a follow-up echocardiography, and a follow-up evaluation of the Epworth Sleepiness Scale (ESS). : From 81 patients with sleep apnea, 72.8% (n = 59) had obstructive sleep apnea (OSA) and 27.2% (n = 22) had central sleep apnea (CSA). There was a statistically significant difference in body mass index (BMI), ESS, systolic blood pressure (SBP), diastolic blood pressure (DBP), and left ventricular ejection fraction (LVEF%) in the group with CPAP therapy compared to the no-CPAP group. The CPAP group had a median survival of 11.7 months vs. 10.1 months in the no-CPAP group (log-rank (Mantel-Cox) = 0.044). : This study suggests that obstructive sleep apnea is a common comorbidity in patients with acute decompensated heart failure. The addition of CPAP therapy in these patients improves the symptoms and the prognosis.
急性失代偿性心力衰竭（ADHF）是一种住院率和死亡率都很高的疾病，而阻塞性睡眠呼吸暂停（OSA）是一种常见的合并症。在家中进行持续气道正压通气（CPAP）治疗对这些患者而言可能是一种很好的辅助非药物治疗方法。
我们对心内科连续收治的150例因心力衰竭加重而住院的患者进行了一项单中心前瞻性队列研究。其中，57例患者患有阻塞性睡眠呼吸暂停。出院后，为他们提供了在家中进行CPAP治疗。我们将他们分为两组，并随访1年。所有患者均接受了最佳药物治疗。在随访期末，患者接受了随访体格检查、随访超声心动图检查以及Epworth嗜睡量表（ESS）的随访评估。
在81例睡眠呼吸暂停患者中，72.8%（n = 59）患有阻塞性睡眠呼吸暂停（OSA），27.2%（n = 22）患有中枢性睡眠呼吸暂停（CSA）。与未接受CPAP治疗的组相比，接受CPAP治疗的组在体重指数（BMI）、ESS、收缩压（SBP）、舒张压（DBP）和左心室射血分数（LVEF%）方面存在统计学显著差异。CPAP组的中位生存期为11.7个月，而未接受CPAP治疗的组为10.1个月（对数秩检验（Mantel-Cox）= 0.044）。
这项研究表明，阻塞性睡眠呼吸暂停是急性失代偿性心力衰竭患者中常见的合并症。在这些患者中增加CPAP治疗可改善症状和预后。
