Sleep disorders in systolic heart failure: A prospective study of 100 male patients. The final report
Sleep disorders in systolic heart failure: A prospective study of 100 male patients. The final report
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DOI：
10.1016/j.ijcard.2004.12.068
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发表时间：
2006-01-04
影响因子：
3.5
通讯作者：
Javaheri, S
中科院分区：
文献类型：
--
作者：
Javaheri, S
背景：心力衰竭是一种非常普遍的疾病。本研究的主要目的是确定心力衰竭中睡眠呼吸暂停和周期性肢体运动（PLMS）的患病率、后果和标志。方法和结果：这是一项前瞻性研究，114例连续符合条件的心力衰竭患者中有100例LVEF < 45%。49%的患者患有睡眠呼吸暂停，平均指数为每小时49。37%的患者患有CSA， 12%的患者患有OSA。CSA患者与无睡眠呼吸暂停患者相比，CSA的相关指标为功能分级差、房颤、PaCO2 < 36 mm Hg、LVEF < 20%、夜间室性心律失常包括bbb30次PVC、>对联和> 1次室性心动过速/小时。相比之下，将合并CSA的心力衰竭患者与OSA患者进行比较，OSA患者明显肥胖（平均体重109 +/- 27 vs 78 +/- 18 kg），并有习惯性打鼾（83% vs 38%）。20%的心力衰竭患者PLMS平均指数为35 /小时。PLMS导致唤醒次数轻度增加（每小时3.4±2次）。结论：49%的男性收缩期心力衰竭患者有睡眠呼吸暂停，20%有PLMS。37%的患者发生CSA， 12%的患者发生OSA。习惯性打鼾和肥胖是阻塞性睡眠呼吸暂停的标志。相比之下，心力衰竭的CSA患者通常很瘦，大多数不打鼾。CSA的标志是III级纽约心脏，房颤，频繁的夜间室性心律失常，低动脉PCO2和LVEF < 20%。2005爱思唯尔爱尔兰有限公司版权所有。
Background: Heart failure is a highly prevalent disorder. The main aims of this study were to determine the prevalence, consequences and markers of sleep apnea and the periodic limb movements (PLMS) in heart failure.Methods and Results: This is a prospective study of 100 of 114 consecutive eligible patients with heart failure and LVEF < 45%. Forty-nine percent of patients had sleep apnea with an average index of 49 per hour. Thirty-seven percent of patients had CSA and 12% had OSA. Comparing patients with CSA to those without sleep apnea, the markers associated with CSA were poorer functional classification, atrial fibrillation, PaCO2 < 36 mm Hg, LVEF < 20%, and nocturnal ventricular arrhythmias including > 30 PVC's, > 1 couplets and > 1 episodes of ventricular tachycardia/hour. In contrast, comparing heart failure patients with CSA to OSA, OSA patients were significantly obese (mean body weight 109 +/- 27 vs 78 +/- 18 kg) and had habitual snoring (83% vs 38%). Twenty percent of patient with heart failure had PLMS with an average index of 35 per hour. PLMS resulted in a mildly increased number of arousals (3.4 +/- 2 per hour).Conclusions: 49% of male patients with systolic heart failure suffer from sleep apnea and 20% have PLMS. CSA occurs in about 37%, and OSA in 12% of patients. Habitual snoring and obesity are the hallmarks of OSA. In contrast, heart failure patients with CSA are commonly thin and mostly do not snore. Hallmarks of CSA are Class III New York Heart, artrial fibrillation, frequent nocturnal ventricular arrhythmias, low arterial PCO2 and LVEF < 20%. (c) 2005 Elsevier Ireland Ltd. All rights reserved.