Subscribe to RSS
DOI: 10.1055/s-2005-863079
© Georg Thieme Verlag Stuttgart · New York
Schlafapnoe: Bedeutung bei Patienten mit Herzinsuffizienz
Pathophysiologie, Diagnostik und TherapieSleep apnea in patients with chronic heart failurePathophysiology, diagnosis and treatmentPublication History
eingereicht: 24.8.2004
akzeptiert: 18.2.2005
Publication Date:
24 February 2005 (online)

Während der letzten 50 Jahre konnte die Prognose der Patienten mit Herzinsuffizienz sowohl durch neue medikamentöse Therapiekonzepte [17] als auch durch interventionelle und chirurgische Revaskularisationsverfahren bei koronarer Herzkrankheit (KHK) sowie in neuerer Zeit durch spezielle antibradykarde und antitachykarde Schrittmachersysteme gebessert werden. Dennoch ist die Letalität der Herzinsuffizienz hoch [25], so dass die Weiterentwicklung neuer Therapieoptionen wünschenswert ist.
Bei der Herzinsuffizienz handelt es sich um ein komplexes Syndrom mit Veränderungen des Sauerstoffaustausches durch eine pulmonalvenöse Stauung oder sowohl restriktive als auch obstruktive Lungenfunktionsstörungen, sowie eine vermehrte Beanspruchung der Atemmuskulatur bei Hyperventilation. Deshalb kommt einem integrativen kardio-pulmonalen Therapiekonzept, das neben der kardiologischen Therapie auch pneumologische Verfahren - wie beispielsweise die atemunterstützende Therapie - umfasst, zunehmende Bedeutung zu.
Literatur
- 1
American Sleep Disorders Association .
Practice parameters for the treatment of snoring and obstructive sleep apnea.
Sleep.
1995;
18
511-513
MissingFormLabel
- 2
Andreas S, Clemens C, Sandholzer H, Figulla H, Kreuzer H.
Improvement of exercise capacity with the treatment of cheyne-stokes respiration in
patients with congestive heart failure.
J Am Coll Cardiol.
1996;
27
1486-1490
MissingFormLabel
- 3
Andreas S, Hagenah G, Möller C, Werner G, Kreuzer H.
Cheyne-Stokes respiration and prognosis in congestive heart failure.
Am J Cardiol.
1996;
78
1260-1264
MissingFormLabel
- 4
Arzt M, Harth M, Luchner A. et al .
Enhanced ventilatory responses to exercise in patients with chronic heart failure
and central sleep apnea.
Circulation.
2003;
107
1998-2003
MissingFormLabel
- 5
Becker H F, Jerrentrup A, Ploch T. et al .
Effect of nasal continuous positive airway pressure treatment on blood pressure in
patients with obstructive sleep apnea.
Circulation.
2003;
107
68-73
MissingFormLabel
- 6
Bradley T D, Floras J S.
Sleep apnea and heart failure. Part I: obstructive sleep apnea.
Circulation.
2003;
107
1671-1678
MissingFormLabel
- 7
Bradley T D, Logan A G, Floras J S.
Rationale and design of the Canadian continuous positive airway pressure trial for
congestive heart failure patients with central sleep apnea.
Can J Cardiol.
2001;
17
677-684
MissingFormLabel
- 8
Douglas N J, Polo O.
Pathogenesis of obstructive sleep apnea/hypopnea syndrome.
Lancet.
1994;
344
653-655
MissingFormLabel
- 9
Duchna H -W, Guilleminault C, Stoohs R A. et al .
Vascular reactivity in obstructive sleep apnea syndrome.
Am J Respir Crit Care Med.
2000;
161
187-191
MissingFormLabel
- 10
Duchna H -W, Guilleminault C, Stoohs R A, Orth M. et al .
Das obstruktive Schlafapnoe-Syndrom: Ein kardiovaskulärer Risikofaktor?.
Z Kardiol.
2001;
90
568-575
MissingFormLabel
- 11
Duchna H -W, Grote L, Andreas S. et al .
State of the art article: Sleep-disordered breathing and cardio- and cerebrovascular
diseases: update 2003 of clinical significance and future perspectives.
Somnologie.
2003;
7
101-121
MissingFormLabel
- 12
Dunai J, Kleiman J, Trinder J.
Ventilatory instability during sleep onset in individuals with high peripheral chemosensitivity.
J Appl Physiol.
1999;
87
661-672
MissingFormLabel
- 13 Fischer J. Schlafbezogene Atmungsstörungen (Apnoe-Syndrom). Auflage 1 Deisenhofen: Dustri-Verlag In: Nolte D, editor. Manuale Pneumologicum 1992: 1-19
MissingFormLabel
- 14
Freimark D, Adler Y, Sheffy J. et al .
Oscillations in peripheral arterial tone in congestive heart failure patients: a new
marker for Cheyne-Stokes breathing.
Cardiology.
2002;
98
21-24
MissingFormLabel
- 15 Guilleminault C. Clinical features and evaluation of obstructive sleep apnea. W.B. Saunders Company, London, Toronto, montreal, Sydney, Tokyo In: Kryger MH, Roth T, Dement WC, editors: Principles and practice of sleep medicine 1994: 667-677
MissingFormLabel
- 16
Hanley P, Zuberi N, Gray R.
Pathogenesis of cheyne-stokes respiration in patients with congestive heart failure.
Relationship to PCO2.
Chest.
1999;
104
1079-1084
MissingFormLabel
- 17
Hoppe U C, Erdmann E.
Leitlinien zur Therapie der chronischen Herzinsuffizienz.
Z Kardiol.
2001;
90
218-237
MissingFormLabel
- 18
Jahaveri S, Corbett W.
Association of low PaO2 with central sleep apnea and ventricular arrhythmias in ambulatory
patients with stable heart failure.
Ann Intern Med.
1998;
128
204-297
MissingFormLabel
- 19
Javaheri S, Parker T J, Liming J. et al .
Sleep apnea in 81 ambulatory male patients with stable heart failure: types and their
prevalences, consequences, and presentations.
Circulation.
1998;
97
2154-2159
MissingFormLabel
- 20
Javerheri S.
A mechanism of central sleep apnea in patients with heart failure.
N Engl J Med.
1999;
341
949-954
MissingFormLabel
- 21
Kaneko Y, Floras J S, Usui K. et al .
Cardiovascular effects of continuous positive airway pressure in patients with heart
failure and obstructive sleep apnea.
N Engl J Med.
2003;
348
1233-1241
MissingFormLabel
- 22
Kelm M, Strauer B E.
Endotheliale Dysfunktion - Therapeutische und prognostische Relevanz.
Internist.
1999;
40
1300-1307
MissingFormLabel
- 23
Lanfranchi P, Braghioli A, Bosimini E. et al .
Prognostic value of nocturnal cheyne -stokes respiration in chronic heart failure.
Circulation.
1999;
99
1435-1440
MissingFormLabel
- 24
Lanfranchi P, Somers V, Braghiroli A. et al .
Central sleep apnea in left ventricular dysfunction. Prevalence and implications for
arrythmic risk.
Circulation.
2003;
107
727-732
MissingFormLabel
- 25
Levy D, Kenchaiah S, Larson M G. et al .
Long-term trends in the incidence of and survival with heart failure.
N Engl J Med.
2002;
347
1397-1402
MissingFormLabel
- 26
Libby P, Ridker P M, Maseri A.
Inflammation and Atherosclerosis.
Circulation.
2002;
105
1135-1143
MissingFormLabel
- 27
Lipkin D.
Sleep disordered breating in chronic stable heart failure.
Lancet.
1999;
354
531-532
MissingFormLabel
- 28
Mansfield D R, Gollogly N C, Kaye D M, Richardson M, Bergin P, Naughton M T.
Controlled trial of continuous positive airway pressure in obstructive sleep apnea
and heart failure.
Am J Respir Crit Care Med.
2004;
169
361-366
MissingFormLabel
- 29
Mansfield D, Kaye D, Brunner L RH, Solin P, Esler M, Naughton M.
Raised sympathetic nerve activity in heart failure and central sleep apnea is due
to heart failure severity.
Circulation.
2003;
107
1396-1400
MissingFormLabel
- 30
Marti S, Sampol G, Munoz X. et al .
Mortality in severe sleep apnoea/hypopnoea syndrome patients: impact of treatment.
Eur Respir J.
2002;
20
1511-1518
MissingFormLabel
- 31
Metha S, Liu P, Fitzgerald F, Allinda Y, Bradley T.
Effects of continuous positive airway pressure on cardiac volumes in patients with
ischemic and dilated cardiomyopathy.
Am J Respir Crit Care Med.
2000;
161
128-134
MissingFormLabel
- 32
Narkiewicz K, van de Borne P, Cooley R L, Dyken M E, Somers V K.
Sympathetic activity in obese subjects with and without obstructive sleep apnea.
Circulation.
1998;
98
772-776
MissingFormLabel
- 33
Narkiewicz K, Kato M, Phillips B G, Pesek C A, Davison D E, Somers V K.
Nocturnal continuous positive airway pressure decreases daytime sympathetic traffic
in obstructive sleep apnea.
Circulation.
1999;
100
2332-2335
MissingFormLabel
- 34
Naughton M T, Benard D, Liu P, Rutherford R, Rankin F, Bradley D.
Effects of nasal CPAP on sympathetic activity in patients with heart failure and central
sleep apnea.
Am J Respir Crit Care Med.
1995;
152
473-479
MissingFormLabel
- 35
Nieto F J, Herrington D M, Redline S, Benjamin E J, Robbins J A.
Sleep apnea and markers of vascular endothelial dysfunction in a large community sample
of older adults.
Am J Respir Crit Care Med.
2004;
169
354-360
MissingFormLabel
- 36 Orth M, Rasche K, Duchna H -W. Konservative Therapie. Blackwell, Berlin, Wien In: Rasche K, Sanner B, Schäfer T, Schläfke ME, Sturm A, Zidek W (HRSG): Schlafbezogene
Atmungsstörungen in Klinik und Praxis 1999: 212-221
MissingFormLabel
- 37
Peperell J C, Ramdassingh-Dow S, Crosthwaite N. et al .
Ambulatory blood pressure after therapeutic and subtherapeutic nasal continuous positive
airway pressure for obstructive sleep apnoea: a randomised parallel trial.
Lancet.
2001;
359
204-210
MissingFormLabel
- 38
Peppard P E, Young T, Palta M, Skatrud J.
Prospective study of the association between sleep-disordered breathing and hypertension.
N Engl J Med.
2000;
342
1378-1384
MissingFormLabel
- 39
Quan S F, Gersh B J.
Cardiovascular consequences of sleep-disordered breathing: past, present and future
- report of a workshop from the national center on sleep disorders research and the
national heart, lung, and blood institute.
Circulation.
2004;
109
951-957
MissingFormLabel
- 40
Sanner B, Hader C, Rasche K.
Das obstruktive Schlafapnoe-Syndrom - Therapie.
Dtsch Med Wochenschr.
2004;
129
570-572
MissingFormLabel
- 41
Schmidt-Nowara W, Lowe A, Wiegand L, Cartwright R, Perez-Guerra F, Menn S.
Oral applicances for the treatment of snoring and obstructive sleep apnea: a review.
Sleep.
1995;
18
501-510
MissingFormLabel
- 42
Schulz R, Schmidt D, Blum A. et al .
Decreased plasma levels of nitric oxide derivates in obstructive sleep apnea: response
to CPAP-Therapy.
Thorax.
2000;
55
1046-1051
MissingFormLabel
- 43
Shahar E, Whitney C W, Redline S. et al .
Sleep-disordered breathing and cardiovascular disease - Cross-sectional results of
the Sleep Heart Health Study.
Am J Respir Crit Care Med.
2001;
163
19-25
MissingFormLabel
- 44
Shamsuzzaman A S, Gersh B J, Somers V K.
Obstructive sleep apnea: implications for cardiac and vascular disease.
JAMA.
2003;
290
1906-1914
MissingFormLabel
- 45
Sin D, Fitzgerald F, Parker J D. et al .
Relationship of systolic BP to obstructive sleep apnea in patients with heart failure.
Chest.
2003;
123
1536-1543
MissingFormLabel
- 46
Sin D, Logan A, Fitzgerald F, Liu P, Bradley T.
Effects of continuous positive airway pressure on cardiovascular outcomes in heart
failure patients with and without cheyne-stokes respiration.
Circulation.
2000;
102
61-66
MissingFormLabel
- 47
Smith R, Ronald J, Delaive K, Walld R, Manfreda J, Kryger M H.
What are obstructive sleep apnea patients being treated for prior to this diagnosis?.
Chest.
2002;
121
164-172
MissingFormLabel
- 48
Solin P, Bergin P, Richardson M, Kaye D, Walters E, Naughton M.
Influence of pulmonary capillary wedge pressure on central apnea in heart failure.
Circulation.
1999;
99
1574-1579
MissingFormLabel
- 49
Somers V K, Dyken M E, Clary M P, Abboud F M.
Sympathetic neural mechanisms in obstructive sleep apnea.
J Clin Invest.
1995;
96
1897-1904
MissingFormLabel
- 50
Steiner S, Perings C.
Pulmonalarterielle Hypertonie und Cor pulmonale bei obstruktiver Schlafapnoe: Pathophysiologie
und klinische Relevanz.
Internist.
1999;
40
739-746
MissingFormLabel
- 51
Steiner S, Schwalen A, Strauer B E.
Kardiologische Diagnostik bei Patienten mit obstruktiver Schlafapnoe.
Dtsch Med Wochenschr.
2002;
38
1958-1962
MissingFormLabel
- 52
Teschler H, Dohring J, Wang Y M, Berthon-Jones M.
Adaptive pressure support servo-ventilation: a novel treatment for Cheyne-Stokes respiration
in heart failure.
Am J Respir Crit Care Med.
2001;
164
614-619
MissingFormLabel
- 53
Thalhofer S A, Kiwus U, Dorow P.
Influence of orthotopic heart transplantation on breathing pattern disorders in patients
with dilated cardiomyopathy.
Sleep Breath.
2000;
4
121-126
MissingFormLabel
- 54
Tremel F, Pepin J L, Veale D. et al .
High prevalence and persistance of sleep apnea in patients referred for acute left
ventricular failure and medically treated over 2 months.
Eur Heart J.
1999;
20
1201-1209
MissingFormLabel
- 55
Trinder J, Merson R, Rosenberg J I, Fitzgerald F, Kleiman J, Bradley D T.
Pathophysiological interactions of ventilation, arousals, and blood pressure oscillations
during cheyne-stokes respiration in patients with heart failure.
Am J Respir Crit Care Med.
2000;
162
808-813
MissingFormLabel
- 56
Yokoe T, Minoguchi K, Matsuo H. et al .
Elevated Levels of C-reactive protein and interleukin-6 in patients with obstructive
sleep apnea syndrome are decreased by nasal continuous positive airway pressure.
Circulation.
2003;
107
1129-1134
MissingFormLabel
- 57
Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S.
The occurence of sleep-disordered breathing among middle-aged adults.
New Engl J Med.
1993;
328
1230-1235
MissingFormLabel
- 58
Hader C, Sanner B, Rasche K.
Das obstruktive Schlafapnoe-Syndrom - Diagnostik.
Dtsch Med Wochenschr.
2004;
129
566-569
MissingFormLabel
Dr. med. Stephan Steiner
Universiätsklinikum Düsseldorf, Klinik für Kardiologie, Pneumologie und Angiologie
Moorenstraße 5
40225 Düsseldorf
Email: Steinest@uni-duesseldorf.de