Effect of Respiratory Therapy on the Prognosis of Chronic Heart Failure Patients Complicated With Sleep-Disordered Breathing - A Pilot Efficacy Trial.
Effect of Respiratory Therapy on the Prognosis of Chronic Heart Failure Patients Complicated With Sleep-Disordered Breathing - A Pilot Efficacy Trial.
复制标题
呼吸治疗对伴有睡眠呼吸障碍的慢性心力衰竭患者预后的影响 - 初步疗效试验。
DOI：
10.1253/circj.cj-15-0702
复制
发表时间：
2016
期刊：
影响因子：
--
通讯作者：
H. Shimokawa
中科院分区：
文献类型：
--
作者：
Hiroyuki Satake;K. Sugimura;Y. Fukumoto;K. Fukuda;M. Nakano;M. Kondo;S. Fukui;H. Ogawa;T. Shinozaki;H. Shimokawa
背景
据报道，睡眠呼吸障碍（SDB）会影响慢性心力衰竭（CHF）患者的死亡率和室性快速心律失常的发生。然而，呼吸治疗（RT）是否会影响合并SDB的CHF患者致命性室性快速心律失常的发生仍有待阐明。
方法和结果
我们前瞻性地研究了 SDB 的严重程度是否与 CHF 患者的致命性心脏事件相关，如果是，SDB 的 RT 是否可以改善预后。我们招募了 95 名稳定型 CHF 患者，对他们进行了过夜测谎仪检查 SDB。 SDB 的严重程度通过呼吸暂停低通气指数 (AHI) 进行量化。所有在初次评估时 AHI ≥10 的患者 (n=42) 均被建议接受 RT，例如家庭氧疗和持续气道正压通气，24 人同意这一点。在29±17个月的随访期间，95例患者中出现8例室性快速心律失常，其中14例死亡。多变量比例风险分析显示，AHI ≥5 是致命性心律失常事件的危险因素（P=0.026）。尽管RT显着降低了AHI，但并没有显着降低事件发生率，但4例接受RT治疗的AHI<5的患者没有出现致命性心律失常事件或死亡。
结论
SDB是一个独立的预后因素，因此是CHF患者的重要治疗靶点。
BACKGROUND
Sleep-disordered breathing (SDB) has been reported to influence mortality and occurrence of ventricular tachyarrhythmia in patients with chronic heart failure (CHF). It remains to be elucidated, however, whether respiratory therapy (RT) can affect the occurrence of fatal ventricular tachyarrhythmia in CHF patients with SDB.
METHODS AND RESULTS
We prospectively examined whether the severity of SDB was associated with fatal cardiac events in CHF patients and, if so, whether RT for SDB improved prognosis. We enrolled 95 patients with stable CHF, in whom SDB was examined on overnight polygraphy. The severity of SDB was quantified using the apnea-hypopnea index (AHI). All patients with AHI ≥10 (n=42) at initial evaluation were recommended to have RT, such as home oxygen therapy and continuous positive airway pressure, and 24 agreed to this. During the follow-up period of 29±17 months, 8 ventricular tachyarrhythmias occurred and 14 of the 95 patients died. On multivariate proportional hazard analysis AHI ≥5 was a risk factor for fatal arrhythmic events (P=0.026). Although RT significantly reduced AHI, it did not significantly reduce the event rates, but 4 patients with AHI <5 on RT had no fatal arrhythmic events or death.
CONCLUSIONS
SDB is an independent prognostic factor and thus an important therapeutic target in CHF patients.
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DOI：
10.1164/rccm.200509-1442oc
发表时间：
2006-04-15
影响因子：
24.7
作者：
Mehra, R;Benjamin, EJ;Redline, S
通讯作者：
Redline, S
影响因子：
2.8
作者：
GUILLEMINAULT, C;CONNOLLY, SJ;WINKLE, RA
通讯作者：
WINKLE, RA
DOI：
10.1056/nejmoa1506459
发表时间：
2015-09-17
期刊：
The New England journal of medicine
影响因子：
--
作者：
Cowie MR;Woehrle H;Wegscheider K;Angermann C;d'Ortho MP;Erdmann E;Levy P;Simonds AK;Somers VK;Zannad F;Teschler H
通讯作者：
Teschler H
影响因子：
37.8
作者：
Narkiewicz, K;Montano, N;Somers, VK
通讯作者：
Somers, VK