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Abstract：
OBJECTIVE: Advances in treatment enables most patients with congenital heart diseases (CHD) to survive into adulthood, implying the need to address comorbid conditions in this growing cohort of patients. The aim of this study was to evaluate the prevalence of sleep-disordered breathing (SDB) and lung function abnormalities in patients with adult congenital heart disease (ACHD).
METHODS: Patients with ACHD underwent level 3 sleep testing (Embletta MPR polygraphy) and pulmonary function testing. Results were stratified by the underlying haemodynamic ACHD lesion group.
RESULTS: Patients with ACHD (n = 100) were middle-aged (42.3 ± 14.6 years), 54% male and slightly overweight (BMI 25.9 ± 5.5 kg/m2). Polygraphy revealed a prevalence of sleep apnoea of 39% with 15% of patients presenting with predominantly obstructive apnoeic episodes, while 23% of patients presenting primarily with central sleep apnoea. The distribution of mild, moderate, and severe sleep apnoea in the total study population was 26%, 7% and 6%, respectively. Comparison of apnoea-hypopnoea index, presence of sleep apnoea, and apnoea severity did not offer significant differences between the four ACHD lesion groups (p = 0.29, p = 0.41 and p = 0.18, respectively). Pulmonary function testing revealed obstructive lung disease in 19 of 100 patients. Concomitant chronic obstructive pulmonary disease and obstructive sleep apnoea were diagnosed in 3% of patients and were associated with profound nocturnal desaturation.
CONCLUSIONS: The findings suggest a mild propensity amongst patients with ACHD to develop SDB that seems to be unaffected by the specific underlying congenital lesion.
METHODS: Patients with ACHD underwent level 3 sleep testing (Embletta MPR polygraphy) and pulmonary function testing. Results were stratified by the underlying haemodynamic ACHD lesion group.
RESULTS: Patients with ACHD (n = 100) were middle-aged (42.3 ± 14.6 years), 54% male and slightly overweight (BMI 25.9 ± 5.5 kg/m2). Polygraphy revealed a prevalence of sleep apnoea of 39% with 15% of patients presenting with predominantly obstructive apnoeic episodes, while 23% of patients presenting primarily with central sleep apnoea. The distribution of mild, moderate, and severe sleep apnoea in the total study population was 26%, 7% and 6%, respectively. Comparison of apnoea-hypopnoea index, presence of sleep apnoea, and apnoea severity did not offer significant differences between the four ACHD lesion groups (p = 0.29, p = 0.41 and p = 0.18, respectively). Pulmonary function testing revealed obstructive lung disease in 19 of 100 patients. Concomitant chronic obstructive pulmonary disease and obstructive sleep apnoea were diagnosed in 3% of patients and were associated with profound nocturnal desaturation.
CONCLUSIONS: The findings suggest a mild propensity amongst patients with ACHD to develop SDB that seems to be unaffected by the specific underlying congenital lesion.
摘要：
目的：治疗的进展使大多数先天性心脏病（CHD）患者能够存活到成年，这意味着需要解决这个不断增长的患者队列中的合并症。这项研究的目的是评估成人先天性心脏病（ACHD）患者的睡眠呼吸障碍（SDB）和肺功能异常的患病率。
方法：ACHD患者接受了3级睡眠测试（EmblettaMPRpolygraphy）和肺功能测试。结果按潜在的血流动力学ACHD病变组分层。
结果：ACHD患者（n=100）为中年（42.3±14.6岁），54％男性和轻度超重（BMI25.9±5.5kg/m2）。测谎仪显示睡眠呼吸暂停的患病率为39%，其中15%的患者表现为主要的阻塞性呼吸暂停发作。而23%的患者主要表现为中枢睡眠呼吸暂停。分布温和，中度,在整个研究人群中，严重的睡眠呼吸暂停占26%，7%和6%，分别。呼吸暂停-呼吸不足指数的比较，睡眠呼吸暂停的存在，和呼吸暂停严重程度在四个ACHD病变组之间没有显着差异（分别为p=0.29，p=0.41和p=0.18）。肺功能检查显示100例患者中有19例患有阻塞性肺疾病。3％的患者诊断出合并的慢性阻塞性肺疾病和阻塞性睡眠呼吸暂停，并与严重的夜间去饱和有关。
结论：研究结果表明，ACHD患者有轻微的发展为SDB的倾向，似乎不受特定的潜在先天性病变的影响。
方法：ACHD患者接受了3级睡眠测试（EmblettaMPRpolygraphy）和肺功能测试。结果按潜在的血流动力学ACHD病变组分层。
结果：ACHD患者（n=100）为中年（42.3±14.6岁），54％男性和轻度超重（BMI25.9±5.5kg/m2）。测谎仪显示睡眠呼吸暂停的患病率为39%，其中15%的患者表现为主要的阻塞性呼吸暂停发作。而23%的患者主要表现为中枢睡眠呼吸暂停。分布温和，中度,在整个研究人群中，严重的睡眠呼吸暂停占26%，7%和6%，分别。呼吸暂停-呼吸不足指数的比较，睡眠呼吸暂停的存在，和呼吸暂停严重程度在四个ACHD病变组之间没有显着差异（分别为p=0.29，p=0.41和p=0.18）。肺功能检查显示100例患者中有19例患有阻塞性肺疾病。3％的患者诊断出合并的慢性阻塞性肺疾病和阻塞性睡眠呼吸暂停，并与严重的夜间去饱和有关。
结论：研究结果表明，ACHD患者有轻微的发展为SDB的倾向，似乎不受特定的潜在先天性病变的影响。
