Javaheri S
Pulmonary Section, Veterans Administration Medical Center, Cincinnati, Ohio 45220, USA.
Sleep. 1996 Dec;19(10 Suppl):S229-31.
Despite recent advances in its treatment, congestive heart failure associated with depressed left ventricular function continues to be associated with excess morbidity and mortality. Multiple factors may contribute to the progressively declining course of heart failure. Nocturnal arterial oxyhemoglobin desaturation caused by sleep-disordered breathing could be a contributing factor, particularly because it has been associated with excess mortality in patients with chronic obstructive pulmonary disease. Cheyne and Stokes were the first to observe periodic breathing in patients with heart failure (Cheyne-Stokes respiration). However, relatively large-scale systematic studies have been performed only recently. We studied 42 patients with stable, optimally treated heart failure, without other co-morbid disorders: 19 patients (45%) had an apnea-hypopnea index of more than 20/hour. These episodes were associated with an excess number of arousals and arterial oxyhemoglobin desaturation. Treatment options include nocturnal administration of oxygen, continuous positive airway pressure (CPAP), and medications such as theophylline. Large-scale studies are needed to evaluate the efficacy of these treatment options on quality of life, morbidity, and mortality of patients with heart failure.
尽管在心力衰竭的治疗方面取得了最新进展，但与左心室功能不全相关的充血性心力衰竭仍然与过高的发病率和死亡率相关。多种因素可能导致心力衰竭病情逐渐恶化。睡眠呼吸紊乱引起的夜间动脉血氧血红蛋白饱和度下降可能是一个促成因素，特别是因为它与慢性阻塞性肺疾病患者的过高死亡率相关。Cheyne和Stokes最先观察到心力衰竭患者的周期性呼吸（潮式呼吸）。然而，相对大规模的系统研究直到最近才开展。我们研究了42例病情稳定、接受最佳治疗且无其他合并症的心力衰竭患者：19例患者（45%）的呼吸暂停低通气指数超过20次/小时。这些发作与过多的觉醒和动脉血氧血红蛋白饱和度下降相关。治疗选择包括夜间吸氧、持续气道正压通气（CPAP）以及使用诸如茶碱之类的药物。需要开展大规模研究来评估这些治疗选择对心力衰竭患者生活质量、发病率和死亡率的疗效。
