Prevalence of sleep-disordered breathing in patients with mitral regurgitation and the effect of mitral valve repair,Sleep and Breathing

当前位置： X-MOL 学术 › Sleep Breath. › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

Prevalence of sleep-disordered breathing in patients with mitral regurgitation and the effect of mitral valve repair
Sleep and Breathing ( IF 2.1 ) Pub Date : 2022-06-20 , DOI: 10.1007/s11325-022-02667-2
Leonie Biener ₁ , Johanna Vogelhuber ₁ , Haron Alboany ₁ , Vedat Tiyerili ₁ , Marcel Weber ₁ , Markus Linhart _{1,

2} , Marc Ulrich Becher ₁ , Alina Schenk ₃ , Georg Nickenig ₁ , Dirk Skowasch ₁ , Carmen Pizarro ₁

Affiliation

Purpose

The relationship between chronic heart failure and sleep-disordered breathing (SDB) has been frequently described. However, little is known about the association of mitral regurgitation (MR) and SDB or the impact of transcatheter mitral valve repair (TMVR) on SDB. Our aims were first to determine the prevalence of SDB in patients with MR, and second to determine the effect of TMVR on SDB.

Methods

Patients with MR being evaluated for TMVR at the University Hospital Bonn underwent polygraphy (PG) to determine the prevalence of SDB. After TMVR, a subset of patients was followed up with transthoracic echocardiography (TTE) and PG to evaluate the effect of TMVR on SDB.

Results

In 53 patients, mean age was 76.0 ± 8.5 years and 62% were male. Patients predominantly had more than moderate mitral regurgitation (94%). SDB was highly prevalent (68%) with predominantly central sleep apnoea (CSA, 67%). After TMVR in 15 patients, the apnoea/hypopnoea index (AHI) and central apnoea index (AI) were significantly reduced among patients with SDB (AHI − 8.0/h, p = 0.021; central AI − 6.9/h, p = 0.046). The left atrial volume index (LAVI) at baseline was significantly higher in patients with CSA than in patients with obstructive sleep apnoea (OSA) and was significantly reduced after TMVR (63.5 ml/m² ± 27.2 vs. 38.3 ml/m² ± 13.0; − 18.4 ml/m², p = 0.027).

Conclusion

SDB, especially CSA, is highly prevalent in patients with mitral regurgitation. In the follow-up cohort TMVR led to a significant reduction of the AHI, predominantly of central events. The findings of the study suggest that TMVR may be a suitable therapy not only for MR but also for the accompanying CSA. LAVI may be a useful indicator for CSA in patients with MR.

中文翻译：

二尖瓣反流患者睡眠呼吸障碍的患病率及二尖瓣修复术的效果

目的

经常描述慢性心力衰竭和睡眠呼吸障碍 (SDB) 之间的关系。然而，关于二尖瓣反流 (MR) 和 SDB 的关联或经导管二尖瓣修复术 (TMVR) 对 SDB 的影响知之甚少。我们的目标首先是确定 MR 患者中 SDB 的患病率，其次是确定 TMVR 对 SDB 的影响。

方法

在波恩大学医院接受 TMVR 评估的 MR 患者接受了多重描记术 (PG) 以确定 SDB 的患病率。TMVR 后，部分患者接受经胸超声心动图 (TTE) 和 PG 随访，以评估 TMVR 对 SDB 的影响。

结果

在 53 名患者中，平均年龄为 76.0 ± 8.5 岁，62% 为男性。患者主要有超过中度的二尖瓣反流 (94%)。SDB 非常普遍 (68%)，主要是中枢性睡眠呼吸暂停 (CSA，67%)。15 名患者进行 TMVR 后，SDB 患者的呼吸暂停/低通气指数 (AHI) 和中枢性呼吸暂停指数 (AI) 显着降低（AHI − 8.0/h，p = 0.021；中枢性 AI − 6.9/h，p = 0.046 ） . CSA 患者的基线左心房容积指数 (LAVI) 显着高于阻塞性睡眠呼吸暂停 (OSA) 患者，并且在 TMVR 后显着降低（63.5 ml/m 2 ± 27.2 vs. 38.3 ml/ ^m 2 ^± 13.0 ; − 18.4 毫升/米² , p = 0.027)。