In-hospital Testing for Sleep-disordered Breathing in Hospitalized Patients With Decompensated Heart Failure: Report of Prevalence and Patient Characteristics
In-hospital Testing for Sleep-disordered Breathing in Hospitalized Patients With Decompensated Heart Failure: Report of Prevalence and Patient Characteristics
复制标题
DOI：
10.1016/j.cardfail.2009.05.005
复制
发表时间：
2009-11-01
影响因子：
6
通讯作者：
Abraham, William T.
中科院分区：
文献类型：
--
作者：
Khayat, Rami N.;Jarjoura, David;Abraham, William T.
背景：50%以上的慢性心力衰竭门诊患者存在睡眠呼吸障碍（SDB）。急性失代偿性心力衰竭（ADHF）住院患者SDB的患病率和类型尚不清楚。方法和结果：对先前未进行SDB检测的ADHF患者进行住院睡眠研究。共有395例ADHF患者在住院期间成功进行了睡眠研究记录。共有298例患者（75%,95% CI[71-80%]）患有SDB，其中226例（57%,95% CI[52-62]）以梗阻性SDB为主，72例（18%,95% CI[14-22]）以中枢性SDB为主。只有25% （95% CI 20-29%）的患者没有SDB。在未选择的阻塞性SDB患者亚组出院后6 - 8周的验证性多导睡眠图显示阻塞性睡眠呼吸暂停（OSA）的100%阳性预测值（95% CI 94-100%）。结论：与稳定型慢性心力衰竭相似，ADHF与SDB的高患病率相关。ADHF患者中以梗阻性为主的SDB患病率高于以中枢性为主的SDB。住院期间梗阻性SDB的存在预示着OSA的诊断。（J heart failure 20091:15:739-746）
Background: Sleep-disordered breathing (SDB) is present in more than 50% of ambulatory patients with chronic heart failure. The prevalence and type of SDB in hospitalized patients with acutely decompensated heart failure (ADHF) are not known.Methods and Results: In-hospital sleep Studies were performed on consecutive patients with ADHF who were not previously tested for SDB. A total of 395 consecutive patients with ADHF underwent successful sleep study recording during hospitalization. A total of 298 patients (75%, 95% CI [71-80%] had SDB; of these, 226 (57%, 95% CI [52-62]) had predominantly obstructive SDB and 72 (18%, 95% CI [14-22]) had predominantly central SDB. Only 25% (95% CI 20-29%) of patients were free of SDB. Validation polysomnography between 6 and 8 weeks after discharge on a Subgroup of unselected patients with obstructive SDB revealed a 100 % positive predictive value (95% CI 94-100%) for obstructive sleep apnea (OSA).Conclusions: Similar to stable chronic heart failure, ADHF is associated with a high prevalence of SDB. The prevalence of predominantly obstructive SDB exceeded that of predominantly central SDB in ADHF patients. The presence of obstructive SDB during hospitalization predicted a diagnosis of OSA oil polysomnography. (J Cardiac Fail 20091:15:739-746)