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Updated: May 9, 2025

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction

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Published on: February 13, 2021

在HFrEF中LV结构和功能有或没有峰值流量触发的自适应式伺服通风处理的睡眠呼吸障碍

Shoichiro Yatsu¹, Anna Woo², Christian M Horvath¹

¹Sleep Research Laboratories of the University Health Network, Toronto Rehabilitation Institute (KITE) and Toronto General Hospital and University of Toronto, Toronto, Canada; Department of Medicine, University Health Network and Sinai Health and University of Toronto, Toronto, Canada.

JACC. Heart failure

|May 1, 2025

概括

睡眠呼吸障碍,特别是中央睡眠呼吸暂停,与心力衰竭患者的心脏功能恶化有关. 然而,在这项研究中,自适应性伺服通风没有改善心脏结构或功能.

科学领域:

心脏病学心脏病学
睡眠医学睡眠医学
肺部病理学肺部病理学

背景情况:

睡眠呼吸障碍 (SDB),包括阻塞性睡眠呼吸暂停 (OSA) 和中央睡眠呼吸暂停 (CSA),涉及促进左心室 (LV) 重塑和静脉功能障碍.
在ADVENT-HF试验中,研究了SDB和可逆性LV结构和功能损伤在心力衰竭患者中与减少射出分数之间的关联.

研究的目的:

为了测试SDB与心力衰竭患者减少射出分数的LV结构和功能的可逆性损伤相关的假设.
为了评估自适应性伺服通风 (ASV) 对患有SDB和心力衰竭的患者的LV结构和功能的影响.

主要方法:

射出分数≤45%的参与者接受了心声回声和多睡眠图.
患者被分为没有SDB (呼吸暂停-呼吸暂停指数[AHI] <15/h),OSA (AHI ≥15/h与≥50%的阻塞性事件) 或CSA (AHI ≥15与>50%的中心事件).
SDB患者被随机分配到对照组或ASV_PF,并在6个月后重复心声扫描.

主要成果:

与没有SDB的患者相比,患有OSA的患者表现出类似的LV结构和功能.
与OSA和非SDB组相比,患有CSA的患者表现出较高的LV质量指数和较低的LV射出分数.
ASV_PF有效地废除了SDB,但在6个月后在整体队列或子组中没有显著改变LV结构或功能.

结论:

在心力衰竭中,OSA与没有SDB相比,与明显的LV结构或功能无关.
CSA与OSA或非SDB相比,与更显著的LV重塑和缩功能障碍有关.
六个月的ASV_PF治疗SDB没有影响LV结构或功能在这个患者群体.

关键词:

中央睡眠呼吸暂停症是什么超声心电图 (Echocardiography) 是一种心声回声仪.左心室重塑的左心室重塑阻塞性睡眠呼吸暂停症是什么随机对照临床试验是随机对照临床试验.

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