【medical-news】利尿剂可改善心衰患者的睡眠呼吸暂停
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Chest 2007;132:440-446.
Diuretics Improve Sleep Apnea in Heart Failure Patients
NEW YORK (Reuters Health) Aug 20 - Use of diuretics in obese patients with diastolic heart failure appears to reduce sleep-disordered breathing, Italian researchers report in the August issue of Chest.
Dr. Caterina B. Bucca and colleagues at the University of Turin note that upper airway edema might contribute to pharyngeal collapsibility and account for the high prevalence of obstructive sleep apnea (OSA) in such patients.
To investigate whether "intensive unloading" with the use of diuretics might help in this situation, the researchers conducted an in-hospital study of 15 patients with severe OSA, hypertension, and diastolic heart failure. They received IV furosemide 20 mg and spironolactone 100 mg twice daily for 3 days.
This diuretic treatment led to a significant reduction in weight (from 111.5 to 109.0 kg), in blood pressure, and apnea-hypopnea index or AHI (from 74.89 to 57.17 events per hour). There also was a significant improvement in the area of the oropharyngeal junction.
In addition, there was a significant increase in measures of upper airway patency, such as forced midinspiratory flow. Weight loss was significantly related to these improvements and to the decrease in AHI.
"These findings," the investigators conclude, "suggest that diuretics may have a beneficial effect in the pharmacologic treatment of sleep apnea" in such patients.
However, they add that "the short-term nature of the observation and the intensive fluid unloading do not warrant definite therapeutic recommendations," and they call for longer-term studies including patients with milder OSA.
Diuretics Improve Sleep Apnea in Heart Failure Patients
NEW YORK (Reuters Health) Aug 20 - Use of diuretics in obese patients with diastolic heart failure appears to reduce sleep-disordered breathing, Italian researchers report in the August issue of Chest.
Dr. Caterina B. Bucca and colleagues at the University of Turin note that upper airway edema might contribute to pharyngeal collapsibility and account for the high prevalence of obstructive sleep apnea (OSA) in such patients.
To investigate whether "intensive unloading" with the use of diuretics might help in this situation, the researchers conducted an in-hospital study of 15 patients with severe OSA, hypertension, and diastolic heart failure. They received IV furosemide 20 mg and spironolactone 100 mg twice daily for 3 days.
This diuretic treatment led to a significant reduction in weight (from 111.5 to 109.0 kg), in blood pressure, and apnea-hypopnea index or AHI (from 74.89 to 57.17 events per hour). There also was a significant improvement in the area of the oropharyngeal junction.
In addition, there was a significant increase in measures of upper airway patency, such as forced midinspiratory flow. Weight loss was significantly related to these improvements and to the decrease in AHI.
"These findings," the investigators conclude, "suggest that diuretics may have a beneficial effect in the pharmacologic treatment of sleep apnea" in such patients.
However, they add that "the short-term nature of the observation and the intensive fluid unloading do not warrant definite therapeutic recommendations," and they call for longer-term studies including patients with milder OSA.
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