在心力衰竭和中央睡眠呼吸暂停中,交感神经活动升高是由于心力衰竭的严重程度
Darren Mansfield1, David M Kaye, Hanspeter Brunner La Rocca
1Department of Respiratory Medicine and Monash University, Alfred Hospital, Melbourne, Victoria, Australia.
Circulation
|March 19, 2003
概括
患有中心睡眠呼吸暂停的充血性心力衰竭患者具有较高的交感神经活动和肺动脉压力. 这些升高与心力衰竭的严重程度有关,而不是睡眠呼吸暂停本身的严重程度.
科学领域:
- 心脏病学 心脏病学
- 睡眠医学 睡眠医学
- 生理学 生理学 生理学
背景情况:
- 带有中心睡眠呼吸暂停 (CHF-CSA) 的充血性心力衰竭与升高的上腺素 (NE) 和肺动脉压力 (PAP) 有关.
- CSA,交感神经活动和CHF严重程度之间的关系尚不清楚.
研究的目的:
- 为了研究中枢睡眠呼吸暂停 (CHF-CSA),阻塞性睡眠暂停 (CHF-OSA) 和正常呼吸 (CHF-N) 的CHF患者的交感神经活动.
- 在CHF患者中,将NE溢出和心脏血液动力学与呼吸暂停严重程度相关联.
主要方法:
- 使用放射性同位素稀释在55名CHF患者中测量了全身和心脏上腺素 (NE) 溢出.
- 根据多睡眠图谱将患者分为CHF-N (19),CHF-OSA (15) 和CHF-CSA (21) 组.
- 评估心脏血液动力学,包括平均肺动脉压 (PAP),通过右心脏导管.
主要成果:
- 与CHF-N和CHF-OSA组相比,CHF-CSA患者的全身和心脏NE溢出显著增加.
- 患有CHF-CSA的患者也显示出明显高于平均PAP的平均值.
- 在控制CHF严重程度后,两组之间没有发现NE动态的显著差异.
- 平均PAP独立与全身和心脏NE溢出相关.
结论:
- 在CHF-CSA中同情神经活动升高与心力衰竭的严重程度有关,而不是呼吸暂停的严重程度.
- 肺动脉平均压力是CHF患者同情性激活的关键决定因素.
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