Cheyne-Stokes 呼吸作为阻塞性睡眠呼吸暂停患者心力衰竭的预测指标；使用连续气道正压远程监测数据的回顾性病例对照研究,Frontiers in Cardiovascular Medicine

当前位置： X-MOL 学术 › Front. Cardiovasc. Med. › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

Cheyne-Stokes 呼吸作为阻塞性睡眠呼吸暂停患者心力衰竭的预测指标；使用连续气道正压远程监测数据的回顾性病例对照研究
Frontiers in Cardiovascular Medicine ( IF 2.8 ) Pub Date : 2022-02-07 , DOI: 10.3389/fcvm.2022.790331
Kimimasa Saito ₁ , Yoko Takamatsu ₁

Affiliation

Objective

我们进行了一项回顾性病例对照研究，以检查 Cheyne-Stokes 呼吸 (CSB) 的远程监测是否有助于预测持续气道正压通气 (CPAP) 的阻塞性睡眠呼吸暂停 (OSA) 患者心力衰竭 (HF) 的发作。

Methods

在我院治疗的 OSA 患者中，2014 年 7 月至 2021 年 5 月期间发生的 HF 患者 33 例[急性 HF（AHF）11 例；22例慢性心力衰竭（CHF）加重]被纳入心力衰竭组。在 618 名稳定患者中，149 名 30 天平均 CSB 率 (CSB%) ≥ 1% 的患者被纳入非心衰对照组。比较 AHF、CHF 和对照组 CSB% 的时间变化。此外，在非心力衰竭对照组的 149 名患者中，有 44 名患者的 CSB%、体重指数和性别以 1:2 的比例与 22 名 CHF 患者匹配。比较三组CSB的平均周期长度（CL）：稳定期CHF（CHF-稳定组）、加重期CHF（CHF-加重组）和对照组。另外，根据HF的状态，

Results

三组间CSB%的时间变化有显着差异。AHF 和 CHF 组在 HF 发作前 CSB% (SD CSB%) 的标准偏差显着高于对照组。CHF 组 CSB 的 CL 明显长于对照组，加重期比稳定期长。可区分有无 HF 发作患者的 CL 的最佳截止值为 68.9 s。

Conclusion

与非 HF 对照组相比，HF 组表现出更大的 CSB 变化和更长的 CL。此外，即使在同一患者中，在 HF 恶化期间 CL 也更长。这些结果表明，对 CSB 变化和 CL 的 CPAP 设备数据的远程监测可能允许早期预测 HF 的发作和恶化。

"点击查看英文标题和摘要"

Cheyne-Stokes Breathing as a Predictive Indicator of Heart Failure in Patients With Obstructive Sleep Apnea; A Retrospective Case Control Study Using Continuous Positive Airway Pressure Remote Monitoring Data

Objective

We conducted a retrospective case control study to examine whether remote monitoring of Cheyne-Stokes breathing (CSB) was useful for predicting the onset of heart failure (HF) in patients with obstructive sleep apnea (OSA) on continuous positive airway pressure (CPAP).

Methods

Among patients with OSA treated at our hospital, 33 patients with HF that occurred between July 2014 and May 2021 [11 patients with acute HF (AHF); 22 patients with chronic HF (CHF) exacerbation] were included in the HF group. Of the 618 stable patients, 149 patients with a 30-days average CSB rate (CSB%) ≧1% were included in the non-HF control group. The chronologic change of CSB% were compared among the AHF, CHF and Control groups. Furthermore, of the 149 patients in the non-HF control group, 44 patients were matched for CSB%, body mass index, and sex in a ratio of 1:2 to 22 patients with CHF. The average cycle length (CL) of CSB was compared among three groups: CHF in stable period (CHF-stable group), CHF in exacerbation period (CHF-exacerbation group), and control group. In addition, according to the status of HF, receiver operating characteristic (ROC) curves were generated to determine the optimal cut-off points for variation of CSB% and CL.

Results

Chronological change in CSB% among the three groups was significantly different. Standard deviation of CSB% (SD CSB%) before onset HF was significantly higher in both the AHF and CHF groups than in the control group. The CL of CSB was significantly longer in the CHF group than in the control group and was longer during the exacerbation period than during the stable period. The optimal cut-off value of CL that could differentiate patients with and without the onset of HF was 68.9 s.

Conclusion

The HF group demonstrated greater CSB variations and longer CL than the non-HF control group. Furthermore, the CL was longer during the exacerbation period of HF even in the same patient. These results suggest that remote monitoring of CPAP device data for CSB variations and CL might allow early prediction of the onset and exacerbation of HF.

更新日期：2022-02-07

点击分享查看原文

点击收藏

公开下载

阅读更多本刊新发论文