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慢性心力衰竭患者的左室重构与睡眠呼吸障碍
引用本文:沈倩波,许顶立,林晟,赖文岩. 慢性心力衰竭患者的左室重构与睡眠呼吸障碍[J]. 南方医科大学学报, 2006, 26(4): 486-489
作者姓名:沈倩波  许顶立  林晟  赖文岩
作者单位:南方医科大学南方医院心内科,广东,广州,510515;南方医科大学南方医院心内科,广东,广州,510515;南方医科大学南方医院心内科,广东,广州,510515;南方医科大学南方医院心内科,广东,广州,510515
摘    要:目的 了解慢性心力衰竭(CHF)患者中睡眠呼吸障碍(SDB)的患病情况及其对左室重构和左心功能的影响。方法对74名CHF患者行随机的床旁EMBLETTA9导联睡眠HOLTER诊断,测定呼吸暂停低通气指数(AHI);并用超声心动图测定心脏左室舒张末内径(LVIDd)、左室重量(LVMW)和左室射血分数(LVEF)。结果46例CHF患者合并SDB,患病率62.16%,其中阻塞性睡眠呼吸暂停发生率31.1%,中枢性睡眠呼吸暂停发生率17.6%。合并SDB患者的LVIDd、LVMW明显增高。LVEF与AHI呈显著负相关(P=0.004,r=0.366)。结论CHF患者中SDB的患病率明显高于一般人群.SDB可能加重CHF患者的左室重构,参与CHF的恶化。在临床T作中应重视对CHF患者的睡眠呼吸障碍的治疗。

关 键 词:慢性心力衰竭  睡眠呼吸障碍  左室重构
文章编号:1673-4254(2006)04-0486-04
收稿时间:2005-08-19
修稿时间:2005-08-19

Sleep-disordered breathing and left ventricular remodeling in patients with chronic heart failure
SHEN Qian-bo,XU Ding-li,LIN Sheng,LAI Wen-yan. Sleep-disordered breathing and left ventricular remodeling in patients with chronic heart failure[J]. Journal of Southern Medical University, 2006, 26(4): 486-489
Authors:SHEN Qian-bo  XU Ding-li  LIN Sheng  LAI Wen-yan
Affiliation:Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. sqb1992@163.com
Abstract:OBJECTIVE:The investigate the prevalence of sleep-disordered breathing (SDB) and evaluate its impact on left ventricular remodeling in adult patients with chronic heart failure (CHF). METHODS: Ambulatory sleep recording for 8 h was performed using Embletta PDS (Medcare, Iceland) in 74 patients with CHF, and the left ventricular ejection fraction (LVEF), internal end-diastolic diameter (LVIDd) and left ventricular mass weight (LVMW) were measured using M-mode and two-dimensional echocardiography. RESULTS: The incidence of SDB defined as an apnea-hypopnea index (AHI, namely the number of apnea-hypopnea events per hour during sleep) no less than 10 was 62.16% in these CHF patients (77.78% in male and 37.93% in female patients). Of the 74 patients 31.1% had mainly obstructive sleep apnea (OSA) and 17.6% had central sleep apnea (CSA). There was a moderate inverse correlation between LVEF and AHI (P=0.004, r=-0.366). LVIDd in patients with CHF and SDB was significantly greater than that in patients with isolated CHF (46.67+/-7.29 vs 55.70+/-11.87 mm, P=0.001). The left ventricular myocardial weight was also greater in patients with CHF and SDB than in patients with isolated CHF (208.58+/-64.19 vs 291.03+/-121.54, P=0.001). CONCLUSION: Our results suggest a higher prevalence of SDB in patients with CHF than in general population, and the prevalence is even higher in patients with severe CHF in relation to left ventricular remodeling. SDB contributes to the progression of CHF and further cardiac decline by a vicious cycle.
Keywords:chronic heart failure   sleep-disordered breathing   left ventricular remodeling
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