Alsughayer Anas, Alharbi Abdulmajeed, Abdelrahman Ahmad, Wesam Mohammed, Kwak Eun Seo, Alfatlawi Halah, Khouri Samer J, Moukarbel George V
Department of Internal Medicine, The University of Toledo, Toledo, OH, USA; Department of Internal Medicine, Ascension Borgess Hospital, Kalamazoo, MI, USA.
Division of Cardiology, Department of Medicine, Tufts Medical Center, Boston, MA, USA.
Respir Med. 2025 Aug-Sep;245:108218. doi: 10.1016/j.rmed.2025.108218. Epub 2025 Jun 21.
Left ventricular assist devices (LVAD) are utilized for stage D Heart Failure (HF) patients refractory to medical and device therapies. Obstructive sleep apnea (OSA) is prevalent in nearly half of HF patients, however few studies exist on the relationship of OSA and outcomes in patients following LVAD implantation. This study aims to enhance the understanding of the interplay between HF, OSA, and complications post-LVAD implantation.
Utilizing the 2020 National Inpatient Sample (NIS) database, a retrospective observational study assessed 22,450 adult patient hospitalizations following LVAD implantation procedure, with 1,964 of those patients having a concomitant diagnosis of OSA.
Among 22,450 adult patients hospitalized following LVAD procedure in 2020, approximately 9% had concomitant OSA. While OSA patients did not have significantly different inpatient mortality, length of stay, or hospital charges compared to non-OSA patients, they had a significantly higher prevalence of atrial fibrillation (37% vs. 26%, p < 0.001). There were no differences in the rates of pulmonary embolism and cerebrovascular accident, and the need for blood transfusion.
OSA is a common comorbidity among patients following LVAD implantation procedures. Our data suggest no relationship between OSA and overall post-operative mortality. The higher prevalence of atrial fibrillation in patients with OSA highlights the need for careful preoperative rhythm assessment and continued monitoring of arrhythmias in this subset of patients. These results add guidance to the shared decision-making with patients being considered for this therapy.
左心室辅助装置（LVAD）用于治疗对药物和器械治疗无效的D期心力衰竭（HF）患者。阻塞性睡眠呼吸暂停（OSA）在近一半的HF患者中普遍存在，然而关于OSA与LVAD植入术后患者预后关系的研究很少。本研究旨在加深对HF、OSA和LVAD植入术后并发症之间相互作用的理解。
利用2020年全国住院患者样本（NIS）数据库，进行一项回顾性观察研究，评估22450例成年患者LVAD植入术后的住院情况，其中1964例患者同时诊断为OSA。
在2020年接受LVAD手术住院的22450例成年患者中，约9%同时患有OSA。与非OSA患者相比，OSA患者的住院死亡率、住院时间或住院费用没有显著差异，但房颤患病率显著更高（37%对26%，p<0.001）。肺栓塞、脑血管意外发生率及输血需求无差异。
OSA是LVAD植入术后患者常见的合并症。我们的数据表明OSA与总体术后死亡率之间没有关系。OSA患者房颤患病率较高，这突出表明需要对这部分患者进行仔细的术前心律评估并持续监测心律失常。这些结果为考虑接受该治疗的患者的共同决策提供了指导。
