睡眠呼吸暂停与心功能不全

Sleep apnea and cardiac dysfunction

呼吸系统和循环系统必须协同作用在细胞及其外循环间运送氧和二氧化碳。循环在呼吸时的变化和持续变化的肺泡通气在心血管系统中均发挥重要作用。这些作用在阻塞性睡眠呼吸暂停患者中表现的尤为明显。近期更多证据表明阻塞性睡眠呼吸暂停会引起和加速左心室肥大和左心功能不全。陈-施呼吸是中枢性睡眠呼吸暂停的一种形式，多见于充血性心力衰竭患者，大量研究表明充血性心力衰竭合并陈-施呼吸会形成恶性循环，通过进一步加重心脏负担而增加患者病死率。

The respiratory and cardiovascular systems must act in concert to transfer oxygen （O2） and carbon dioxide （CO2） between the atmosphere and the cells. Both cyclic changes in breathing and sustained changes in alveolar ventilation exert important effects on the cardiovascular system. These effects are particularly prominent in patients with obstructive sleep apnea （OSA）. More recently, there is a growing body of evidence implicating OSA in the development or progression of left ventricular hypertrophy and dysfunction. Cheyne-Stokes respiration （CSR） is a form of central sleep apnea （CSA）, it is common in patients with congestive heart failure （CHF）, and there is increasing evidence to suggest that CSR-CSA in patients with CHF participates in a vicious cycle that further stresses the failing heart and, in doing so, increases the risk of mortality.