期刊
CIRCULATION JOURNAL
卷 80, 期 7, 页码 1571-1577出版社
JAPANESE CIRCULATION SOC
DOI: 10.1253/circj.CJ-16-0205
关键词
Exercise capacity; Heart failure; Insomnia; Prognosis; Renin-angiotensin-aldosterone system
资金
- Japan Society for the Promotion of Science [25461061]
- Japanese Ministry of Health, Labor, and Welfare, Tokyo, Japan
- Grants-in-Aid for Scientific Research [15K09143, 16K09447] Funding Source: KAKEN
Background: Insomnia is associated with incident heart failure (HF), but the clinical significance and impact of insomnia on HF remain unclear. Methods and Results: Consecutive 1,011 patients admitted for HF were divided into 2 groups according to the presence of insomnia: HF with insomnia (insomnia group, n=519) and HF without insomnia (non-insomnia group, n=492). We compared (1) cardiac event rates including cardiac death and worsening HF; and (2) underlying clinical background including laboratory data, echocardiographic data, and cardiopulmonary exercise test between the 2 groups. On Kaplan-Meier analysis, cardiac event rate was significantly higher in the insomnia group than in the noninsomnia group (39.1 vs. 23.4%, P<0.001). The insomnia group, as compared with the non-insomnia group, had (1) higher plasma renin activity (P=0.042), renin concentration (P=0.007), and aldosterone (P=0.047); (2) lower peak (V) over dotO(2) (14.9 vs. 16.3 ml/kg/min, P=0.002) and higher (V) over dotE/(V) over dotCO(2) slope (36.0 vs. 33.5, P=0.001); and (3) similar B-type natriuretic peptide and left ventricular ejection fraction. Importantly, on multivariate Cox proportional hazard analysis after adjusting for potential confounding factors, insomnia was an independent predictor of cardiac events in HF patients (hazard ratio, 1.899; P<0.001). Conclusions: Insomnia is an independent predictor of cardiac events in HF patients. HF patients with insomnia have activated renin-angiotensin-aldosterone system and lower exercise capacity.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据