Schäfer H, Ewig S, Hasper E, Koehler U, Oehm S, Pizzulli L, Lüderitz B
Medizinische Universitätsklinik und Poliklinik Bonn.
Z Kardiol. 1996 Oct;85(10):768-75.
Obstructive sleep apnea (OSA) and coronary heart disease (CHD) are both frequent in the middle ages. Both disease share a similar spectrum or risk factors and attendant diseases. The aim of the study was to determine the prevalence of obstructive sleep apnea in patients with coronary heart disease diagnosed by coronary angiography. Furthermore, influence of sleep apnea and attendant diseases and risk factors for coronary heart disease, especially the risk for myocardial infarction and reduced left ventricular ejection fraction, was investigated. We included in this study 143 patients (121 men, 22 women mean age 60 +/- 8 years (35-81) who underwent coronary angiography because of angina pectoris or were suspicious for CHD due to noninvasive investigations. These patients has symptoms of OSA based on a standardized questionnaire. They underwent a four-channel screening with a non-laboratory-monitoring-system (NLMS) for detection of sleep-related breathing disorders. In addition, spectrum of risk factors and concomitant diseases were considered. Sleep apnea was more frequent in patients with CHD (30.6%) in comparison to patients without CHD (21.8%), but did not reach statistical significance. Patients with CHD and OSA had a significantly higher frequency of a history of myocardial infarction and had a significantly lower left ventricular ejection fraction than patients without OSA.
Patients with the combination of OSA and CHD are at higher risk for myocardial infarction and reduced left ventricular ejection fraction. Patients with CHD should be screened for OSA in case of secondary prevention.
阻塞性睡眠呼吸暂停(OSA)和冠心病(CHD)在中年人群中都很常见。这两种疾病具有相似的一系列风险因素和伴随疾病。本研究的目的是确定经冠状动脉造影诊断为冠心病的患者中阻塞性睡眠呼吸暂停的患病率。此外,还研究了睡眠呼吸暂停及其伴随疾病和冠心病风险因素的影响,尤其是心肌梗死风险和左心室射血分数降低的情况。我们纳入了143例患者(121例男性,22例女性,平均年龄60±8岁(35 - 81岁)),这些患者因心绞痛接受冠状动脉造影,或因无创检查怀疑患有冠心病。根据标准化问卷,这些患者有阻塞性睡眠呼吸暂停的症状。他们使用非实验室监测系统(NLMS)进行了四通道筛查,以检测与睡眠相关的呼吸障碍。此外,还考虑了风险因素和伴随疾病的范围。与无冠心病的患者(21.8%)相比,冠心病患者中睡眠呼吸暂停更为常见(30.6%),但未达到统计学显著性。与无阻塞性睡眠呼吸暂停的患者相比,患有冠心病和阻塞性睡眠呼吸暂停的患者有心肌梗死病史的频率显著更高,左心室射血分数显著更低。
阻塞性睡眠呼吸暂停和冠心病合并患者发生心肌梗死和左心室射血分数降低的风险更高。在二级预防中,冠心病患者应筛查阻塞性睡眠呼吸暂停。