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射血分数保留的心力衰竭患者中低氧血症与生活质量及睡眠呼吸障碍之间的关联

Association between hypoxemia and quality of life in patients with heart failure with preserved ejection fraction and sleep-disordered breathing.

作者信息

Sawatari Hiroyuki, Magota Chie, Kadokami Toshiaki, Nakamura Ryo, Hayashi Atsumi, Ando Shin-Ichi

机构信息

Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.

School of Medicine, Kurume University, Kurume, Fukuoka, Japan.

出版信息

Sleep Biol Rhythms. 2024 Nov 5;23(1):85-93. doi: 10.1007/s41105-024-00554-9. eCollection 2025 Jan.

Abstract

UNLABELLED

Sleep-disordered breathing is common among patients with heart failure with preserved ejection fraction (HFpEF), and might impact their quality of life due to nighttime hypoxemia and awakenings. However, the factors contributing to deterioration in quality of life remain unclear. This study investigated the factors associated with quality of life deterioration in patients with HFpEF and sleep-disordered breathing. This prospective cross-sectional study included inpatients with HFpEF (left ventricular ejection fraction of ≥ 50%). Sleep-disordered breathing and quality of life were evaluated using polysomnography and the Short Form-8 Health Survey, respectively. The patients were grouped based on thei median physical and mental component summary Short Form-8 Health Survey scores. Among the 31 patients with HFpEF (aged 73.7 ± 10.9 years; 67.7% women; left ventricular ejection fraction, 65.3% ± 8.1%), the median apnea-hypopnea index was 11.5 per hour. Although no differences in parameters related to sleep-disordered breathing were found among the physical component summary-stratified groups, the low mental component summary group exhibited significantly lower nadir oxygen saturation than those exhibited by the high mental component summary group (84.3 ± 5.7% vs. 88.5 ± 3.9%; p = 0.02); this difference remained significant even when adjusted for potential confounders (β = 0.43; p = 0.02). Nocturnal hypoxemia may be a contributing factor to the decline in the mental health aspect of quality of life in patients with HFpEF. Thus, clinicians should consider hypoxemia when managing HFpEF and sleep-disordered breathing.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s41105-024-00554-9.

摘要

未标注

睡眠呼吸障碍在射血分数保留的心力衰竭(HFpEF)患者中很常见,可能由于夜间低氧血症和觉醒而影响他们的生活质量。然而,导致生活质量恶化的因素仍不清楚。本研究调查了HFpEF和睡眠呼吸障碍患者生活质量恶化的相关因素。这项前瞻性横断面研究纳入了HFpEF住院患者(左心室射血分数≥50%)。分别使用多导睡眠图和简短健康调查-8评估睡眠呼吸障碍和生活质量。患者根据简短健康调查-8身体和心理成分总结得分的中位数进行分组。在31例HFpEF患者中(年龄73.7±10.9岁;67.7%为女性;左心室射血分数65.3%±8.1%),呼吸暂停低通气指数中位数为每小时11.5次。尽管在身体成分总结分层组中未发现与睡眠呼吸障碍相关参数的差异,但心理成分总结得分低的组夜间最低氧饱和度显著低于心理成分总结得分高的组(84.3±5.7%对88.5±3.9%;p=0.02);即使在调整潜在混杂因素后,这种差异仍然显著(β=0.43;p=0.02)。夜间低氧血症可能是HFpEF患者生活质量心理健康方面下降的一个促成因素。因此,临床医生在管理HFpEF和睡眠呼吸障碍时应考虑低氧血症。

补充信息

在线版本包含可在10.1007/s41105-024-00554-9获取的补充材料。

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