在心力衰竭患者中治疗中心睡眠呼吸暂停的夜间氧气疗法:多站点,双盲,假冒控制的随机临床试验 (LOFT-HF)
Susan Redline1, Dongdong Li2, Shahrokh Javaheri3
1Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Annals of the American Thoracic Society
|September 10, 2025
概括
夜间氧气疗法 (NOT) 没有改善中枢睡眠呼吸暂停 (CSA) 和心力衰竭减少排气分数 (HFrEF) 的患者的临床结果,尽管改善了睡眠呼吸障碍. 这项研究因招生速度缓慢而提前停止.
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:
- 缺乏足够的证据来管理心力衰竭中的中枢睡眠呼吸暂停 (CSA) 与减少喷射率 (HFrEF).
- 夜间氧气疗法 (NOT) 是对HFrEF中CSA的潜在干预措施,但需要严格研究.
研究的目的:
- 在接受基于指导方针的治疗的HFrEF患者中,评估 NOT 与虚假 NOT 的疗效.
- 评估死亡率,心血管干预或因心力衰竭恶化而住院治疗的综合结果.
主要方法:
- 进行了一项多站点,双盲,假控制的随机试验.
- 98名患有HFrEF和CSA的参与者被随机分配和跟踪.
- 考克斯的比例风险回归模型分析了时间到事件的结果.
主要成果:
- 该研究因招生速度缓慢而过早终止.
- 在NOT和对照组之间的初级复合终点中没有发现显著差异 (HR 1.46,95%CI 0.65-3.29).
- 没有改善睡眠障碍呼吸指数和夜间氧化,但没有影响患者报告的结果.
结论:
- 这项提前终止的试验表明,在HFrEF患者中,NOT对CSA没有临床效果.
- 需要进一步的研究来证实这些发现,尽管睡眠参数有所改善.
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