心不全患者における閉塞性睡眠時無呼吸症の致死性心室性不整脈発生に与える影響

概要

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Objectives: To examine the impact of obstructive sleep apnea (OSA) on life-threatening ventricular arrhythmia in patients with heart failure (HF) and implantable cardioverter-defibrillator (ICD). Background: It is thought that OSA is associated with cardiac arrhythmia and sudden cardiac death. However, it remains unclear whether the presence of OSA increases the risk of life-threatening ventricular arrhythmia in patients with HF. Methods: We prospectively studied 71 consecutive HF patients who were followed for 180 days after a sleep study. All patients had an ICD for primary or secondary prevention. Baseline clinical characteristics and the frequency of appropriate ICD therapy for life-threatening ventricular arrhythmia were compared between patients with and without OSA. Results: OSA was diagnosed in 51 % of 71 patients. There were no statistical differences between patients with and without OSA in baseline cardiac functions. However, during follow-up, appropriate ICD therapies occurred more frequently in patients with OSA (42%) than in those without OSA (17%, p=0.041). On multivariate analysis, the presence of OSA was an independent predictor for appropriate ICD therapy (HR 3.58, 95% CI 0.97-13.3, p=0.045). Conclusions: In patients with HF, the presence of OSA was an independent predictor for life-threatening ventricular arrhythmias.
東京女子医科大学の論文