阻害性睡眠時無呼吸症候群は,左心室のダイアストリック機能に影響する:男性における鼻の連続的な陽性呼吸道圧力の影響
Miguel A Arias1, Francisco García-Río, Alberto Alonso-Fernández
1Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain.
Circulation
|July 13, 2005
まとめ
阻害性睡眠無呼吸症候群 (OSAS) は,左心室のダイアストリック機能に独立して影響します. 鼻経連続正気圧 (nCPAP) 治療は,OSAS患者におけるこれらの初期段階のダイアストリック異常を逆転させることができます.
科学分野:
- 心臓病学 心臓病学
- スリープ・メディシン (睡眠医学)
- 内科内科は,内科の内科である.
背景:
- 阻害性睡眠無呼吸症候群 (OSAS) は,その全身的効果のためにますます認識されています.
- 左心室のダイアストリック機能不全は,未治療のOSASの潜在的な結果です.
- ディアストリック異常におけるOSASの独立した役割については,さらなる解明が必要である.
研究 の 目的:
- 閉塞性睡眠時無呼吸症候群 (OSAS) を,左心室のダイアストリック異常の独立した危険因子として調査する.
- OSAS患者における透析機能の改善における鼻連続正気圧 (nCPAP) の有効性を試験する.
主な方法:
- 27人の中年男性OSAS患者と15人の健康な対照群を対象とした前向き,ランダム化,プラセボ対照,ダブルブラインドクロスオーバー研究です.
- OSASの患者は12週間の偽のnCPAPと12週間の有効なnCPAPを受けていました.
- エコーカルディオグラフィー,血圧,尿中のカテキオラミンは,入院前および各治療後に評価されました.
主要な成果:
- ベースラインのダイアストリック異常は,対照群 (3/15) と比較して,OSAS患者 (15/27) でより一般的であった.
- リラクゼーション障害は,観察された最も一般的な下痢性異常でした.
- 効果的なnCPAP治療は,E/A比率を大幅に改善し,ミトラル減速とイソボラムのリラックス時間を短縮しました.
結論:
- OSASは,他の危険因子とは無関係に,左心房のダイアストリック機能障害に寄与する.
- 慢性的なnCPAP治療は,ダイアストリック異常の進行を防ぐことができます.
- nCPAPは,重要な構造的変化が起こる前に,OSAS患者の初期段階のダイアストリック変化を逆転させることができる.
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