IJC:缓解SDB可改善CHF患者心功能和左心室逆向重构

2013-09-26 佚名 丁香园

研究要点: 1.睡眠呼吸障碍对慢性心力衰竭患者的心脏构型和功能不利。 2.雅典红十字医院Gerasimos Filippatos等人研究发现,有效缓解睡眠呼吸障碍可改善患者的左右心室收缩功能和左心室逆向重构。 睡眠呼吸障碍(SDB)在慢性心力衰竭(CHF)患者中非常高发,并且对心脏构型和功能都会产生不利影响。已有研究证明持续气道正压通气(CPAP)可有效治

研究要点:

1.睡眠呼吸障碍对慢性心力衰竭患者的心脏构型和功能不利。

2.雅典红十字医院Gerasimos Filippatos等人研究发现,有效缓解睡眠呼吸障碍可改善患者的左右心室收缩功能和左心室逆向重构。

睡眠呼吸障碍(SDB)在慢性心力衰竭(CHF)患者中非常高发,并且对心脏构型和功能都会产生不利影响。已有研究证明持续气道正压通气(CPAP)可有效治疗阻塞性睡眠窒息症(OSA),而伺服通气(ASV)对治疗中枢性呼吸暂停(CSA)更有效。选择不同疗法和有效缓解呼吸暂停对心脏功能和左心室逆向重构(r-LVR)的影响尚未得到阐明。雅典红十字医院Gerasimos Filippatos等人对此进行了研究,结果发现,缓解SDB可改善左心室、右心室收缩功能和r-LVR,研究结果发表于《国际心脏病学》杂志。【原文下载】

研究人员检查了85名稳定CHF患者,诊断其是否患有SDB,并进行多导睡眠描记,根据SDB种类进行治疗。治疗开始前和有效治疗6个月后,对患者进行临床评估和全面超声心动图研究。

研究分析了接受有效治疗的17名依从性较好的患者,其中8名OSA患者接受自动CPAP治疗,9名CSA患者接受ASV治疗。研究记录了两组患者所有可测量的常规和TDI左室收缩指数,包括LVEF.治疗后,左室收缩末期容积减少可预测r-LVR.此外,右室收缩参数也显著增加,而右心尺寸和面积治疗后减小,提示肺血流动力学得到改善。随访六个月后,纽约心脏协会心功能分级评估发现患者的临床状态得到了显著改善。

本次研究表明,慢性心力衰竭患者中,睡眠呼吸障碍的有效缓解与左心室和右心室收缩功能和r-LVR的改善有关,不过,我们还需要更多的纵向研究对发病率和死亡率进行评估。

原文下载

Spiros P. Kourouklis, Emmanouil Vagiakis, Ioannis A. Paraskevaidis, Dimitrios Farmakis, Konstantinos Kostikas, John T. Parissis, Apostolos Katsivas, Dimitrios T. Kremastinos, Maria Anastasiou-Nana, Gerasimos Filippatos.Effective sleep apnoea treatment improves cardiac function in patients with chronic heart failure.Int J Cardiol. 2013 Sep 20.


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    2013-12-03 DEXTER3139
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    2014-05-03 xiaoyeshuang
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