Nocturnal Rostral Fluid Shift A Unifying Concept for the Pathogenesis of Obstructive and Central Sleep Apnea in Men With Heart Failure
Nocturnal Rostral Fluid Shift A Unifying Concept for the Pathogenesis of Obstructive and Central Sleep Apnea in Men With Heart Failure
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DOI：
10.1161/circulationaha.109.902452
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发表时间：
2010-04-13
期刊：
影响因子：
37.8
通讯作者：
Bradley, T. Douglas
中科院分区：
文献类型：
--
作者：
Dai Yumino;Redolfi, Stefania;Bradley, T. Douglas
阻塞性睡眠呼吸暂停（OSA）和中枢性睡眠呼吸暂停在心力衰竭患者中很常见。我们假设，在这些患者中，OSA的严重程度与夜间吻侧腿部液体移位和颈围增加有关，中枢性睡眠呼吸暂停的严重程度与夜间吻侧液体移位和睡眠PCO 2有关，持续气道正压通气可减轻阻塞性睡眠呼吸暂停综合征，并可预防颈部积液。（射血分数= 50%的阻塞性呼吸暂停和呼吸不足）和中枢优势组（>50%的中枢事件）。OSA患者接受持续气道正压通气治疗。梗阻型患者夜间下肢液体量变化与夜间颈围变化呈负相关（r =-0.780，P
Background-Obstructive sleep apnea (OSA) and central sleep apnea are common in patients with heart failure. We hypothesized that in such patients, severity of OSA is related to overnight rostral leg fluid displacement and increase in neck circumference, severity of central sleep apnea is related to overnight rostral fluid displacement and to sleep PCO2, and continuous positive airway pressure alleviates OSA in association with prevention of fluid accumulation in the neck.Methods and Results-In 57 patients with heart failure (ejection fraction = 50% of apneas and hypopneas obstructive) and a central-dominant group (>50% of events central). Patients with OSA received continuous positive airway pressure. In obstructive-dominant patients, there were inverse relationships between overnight change in leg fluid volume and both the overnight change in neck circumference (r = -0.780, P