Association between sleep-disordered breathing and arterial stiffness in heart failure patients with reduced or preserved ejection fraction.
Association between sleep-disordered breathing and arterial stiffness in heart failure patients with reduced or preserved ejection fraction.
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DOI：
10.1002/ehf2.12273
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发表时间：
2018-06
影响因子：
3.8
通讯作者：
Takeishi Y
中科院分区：
文献类型：
--
作者：
Suzuki S;Yoshihisa A;Sato Y;Watanabe S;Yokokawa T;Sato T;Oikawa M;Kobayashi A;Yamaki T;Kunii H;Nakazato K;Suzuki H;Saitoh SI;Ishida T;Takeishi Y
睡眠呼吸障碍（SDB）与动脉硬化有关，这可能是导致心力衰竭（HF）的因素之一。我们研究了射血分数降低的心力衰竭（HFrEF）和射血分数保留的心力衰竭（HFpEF）患者的脉搏波速度（PWV）与SDB之间的关系。我们通过多导睡眠图、超声心动图参数和PWV测量了221例HF患者的呼吸暂停低通气指数（AHI）。HFpEF（射血分数> 50%，n = 70）患者的年龄、血压和PWV高于HFrEF（射血分数<50%，n = 151）患者。所有HF患者根据AHI分为三组：无至轻度SDB组（AHI < 15次/h，n = 77）、中度SDB组（15 < AHI < 30次/h，n = 59）和重度SDB组（AHI > 30次/h，n = 85）。虽然三组之间的血压和超声心动图参数没有差异，但重度SDB组的PWV显著高于无至轻度和中度SDB组（P = 0.002）。当分别分析HFrEF和HFpEF患者时，HFpEF患者中重度SDB组的PWV显著高于无至轻度和中度SDB组（P = 0.002），但HFrEF患者中无PWV（P = 0.068）。在确定PWV的多元回归分析中，发现重度SDB的存在是HFpEF患者高PWV的独立预测因素（β = 0.234，P = 0.005），但在HFrEF患者中并非如此。重度SDB与动脉僵硬度升高相关，可能与HF的病理生理学相关，尤其是在HFpEF患者中。
Sleep‐disordered breathing (SDB) is associated with arterial stiffness, which may be one of the factors that lead to heart failure (HF). We examined the relationship between pulse wave velocity (PWV) and SDB in patients who have HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). We measured the apnoea–hypopnoea index (AHI) by polysomnography, echocardiographic parameters, and PWV in 221 HF patients. Age, blood pressure, and PWV were higher in HFpEF (ejection fraction > 50%, n = 70) patients than in HFrEF (ejection fraction < 50%, n = 151) patients. All HF patients were divided into three groups according to AHI: none‐to‐mild SDB group (AHI < 15 times/h, n = 77), moderate SDB group (15 < AHI < 30 times/h, n = 59), and severe SDB group (AHI > 30 times/h, n = 85). Although blood pressure and echocardiographic parameters did not differ among the three groups, PWV was significantly higher in the severe SDB group than in the none‐to‐mild and moderate SDB groups (P = 0.002). When the HFrEF and HFpEF patients were analysed separately, PWV was significantly higher in the severe SDB group than in the none‐to‐mild and moderate SDB groups in patients with HFpEF (P = 0.002), but not in those with HFrEF (P = 0.068). In the multiple regression analysis to determine PWV, the presence of severe SDB was found to be an independent predictor of high PWV in HFpEF (β = 0.234, P = 0.005), but not in HFrEF patients. Severe SDB is associated with elevated arterial stiffness and may be related to the pathophysiology of HF, especially in HFpEF patients.
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影响因子：
37.8
作者：
Kawaguchi, M;Hay, I;Kass, DA
通讯作者：
Kass, DA
影响因子：
6
作者：
Desai, Akshay S.;Mitchell, Gary F.;Creager, Mark A.
通讯作者：
Creager, Mark A.
影响因子：
39.3
作者：
Jackson, Colette E.;Castagno, Davide;McMurray, John J. V.
通讯作者：
McMurray, John J. V.
影响因子：
2.5
作者：
Kartali, Nikoleta;Daskalopoulou, Euphemia;Karagiannis, Asterios
通讯作者：
Karagiannis, Asterios
影响因子：
3.2
作者：
Drager, Luciano F.;Diegues-Silva, Luzia;Krieger, Eduardo M.
通讯作者：
Krieger, Eduardo M.