Assessment of respiratory disturbance index determined with a non-restrictive monitor and of autonomic nervous system parameters in heart failure patients: A pilot study.
Assessment of respiratory disturbance index determined with a non-restrictive monitor and of autonomic nervous system parameters in heart failure patients: A pilot study.
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DOI：
10.1016/j.jjcc.2014.12.018
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发表时间：
2015-09
影响因子：
2.5
通讯作者：
S. Shimazu;A. Hirashiki;Y. Kamimura;Y. Nakano;S. Adachi;T. Kondo;T. Murohara
中科院分区：
文献类型：
--
作者：
S. Shimazu;A. Hirashiki;Y. Kamimura;Y. Nakano;S. Adachi;T. Kondo;T. Murohara
交感神经过度活动与睡眠呼吸障碍（SDB）之间存在联系，两者都是心力衰竭发展的重要指标。为了管理越来越多的心力衰竭患者，任何用于检查他们的方法都需要尽可能的无创、简单和经济。本研究的目的是评估非限制性监测对心力衰竭患者SDB的筛查和自主神经系统的影响。方法49例心力衰竭加重住院患者，平均年龄67岁，男性占78%。在适当的药物治疗稳定后，每位患者同时使用SD-101 （Kenzmedico Co. Ltd, Saitama, Japan）进行睡眠呼吸暂停综合征（SAS）筛查，这是一种新型的、非限制性的、片状的SAS筛查监测仪，并使用动态心电图仪评估心率变异性（HRV）。此外，我们用爱普沃斯嗜睡量表来评估白天的嗜睡。结果平均呼吸障碍指数（RDI）为21.9次/h。男性的RDI值显著高于女性（24.5±11.2事件/h vs 13.0±6.2事件/h，p< 0.001）。SD-101检测的RDI与Holter心电图仪测得的心率指数循环变化密切相关（r= 0.843）。血浆脑钠肽水平与HRV无相关性，血浆去甲肾上腺素水平与HRV总低高频比有较好的相关性（r= 0.529）。结论ssas筛查对心力衰竭患者有重要意义，因为没有主观嗜睡并不能可靠地排除SDB。SD-101的SAS筛选可能适用于治疗心力衰竭。
BackgroundThere is a link between sympathetic overactivity and sleep-disordered breathing (SDB), and both of which are important indicators of the development of heart failure. To manage the increasing numbers of heart failure patients, any method used to check for them needs to be as non-invasive, simple, and cost-effective as possible. The purpose of this study is to assess screening of SDB with a non-restrictive monitor and the autonomic nervous system in heart failure patients.MethodsThe subjects were 49 patients (mean age: 67 years; male: 78%) hospitalized for worsening heart failure. After stabilization with appropriate medical therapy, each patient simultaneously underwent sleep apnea syndrome (SAS) screening with the SD-101 (Kenzmedico Co. Ltd., Saitama, Japan), which is a novel, non-restrictive, sheet-like monitor for SAS screening, and assessment of heart rate variability (HRV) with a Holter monitor. In addition, we assessed daytime sleepiness by using the Epworth Sleepiness Scale.ResultsThe mean respiratory disturbance index (RDI) was 21.9 events/h. Males had significantly greater RDI values than females (24.5 ± 11.2 events/h vs. 13.0 ± 6.2 events/h,p< 0.001). RDI on SD-101 testing was closely correlated with cyclic variation of heart rate index obtained with a Holter electrocardiogram scanner (r= 0.843). Although plasma brain natriuretic peptide level was not correlated with HRV, plasma norepinephrine level was moderately well correlated with the total low- to high-frequency ratio of HRV (r= 0.529).ConclusionsSAS screening is important for heart failure patients, because absence of subjective sleepiness is not reliable in ruling out SDB. The SAS screening with SD-101 might apply for managing heart failure.