A State-of-the-Art Review on Sleep Apnea Syndrome and Heart Failure

Piccirillo, Francesco; Crispino, Simone Pasquale; Buzzelli, Lorenzo; Segreti, Andrea; Incalzi, Raffaele Antonelli; Grigioni, Francesco

doi:10.1016/j.amjcard.2023.02.020

Cited by 5 publications

(3 citation statements)

References 132 publications

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“…There are several mechanisms by which OSA causes adverse hemodynamic consequences for HF patients. An occluded airway reduces intrathoracic pressure with inspiration, increasing venous return and right ventricular distension, while reducing left ventricular (LV) filling, increasing LV transmural pressure, and increasing afterload [ 109 , 110 ]. Afterload and myocardial oxygen demand also increase due to the sympathetic stimulus and hypertension induced by recurrent hypoxia, which can result in LV remodeling and hypertrophy over time [ 111 , 112 ].…”

Section: Osa As a Risk Factor For Cvdmentioning

confidence: 99%

The Role of Sleep in Cardiovascular Disease

Jaspan,

Greenberg,

Parihar

et al. 2024

Curr Atheroscler Rep

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Purpose of Review Sleep is an important component of cardiovascular (CV) health. This review summarizes the complex relationship between sleep and CV disease (CVD). Additionally, we describe the data supporting the treatment of sleep disturbances in preventing and treating CVD. Recent Findings Recent guidelines recommend screening for obstructive sleep apnea in patients with atrial fibrillation. New data continues to demonstrate the importance of sleep quality and duration for CV health. Summary There is a complex bidirectional relationship between sleep health and CVD. Sleep disturbances have systemic effects that contribute to the development of CVD, including hypertension, coronary artery disease, heart failure, and arrhythmias. Additionally, CVD contributes to the development of sleep disturbances. However, more data are needed to support the role of screening for and treatment of sleep disorders for the prevention of CVD.

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Section: Osa As a Risk Factor For Cvdmentioning

confidence: 99%

The Role of Sleep in Cardiovascular Disease

Jaspan,

Greenberg,

Parihar

et al. 2024

Curr Atheroscler Rep

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“…3,4 There is mounting evidence indicating that OSA serves as an independent risk factor for several cardiovascular diseases, including hypertension, 5 stroke, 6 pulmonary hypertension, 7 and heart failure. 8 Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is recognized as the third most common cardiovascular disease worldwide. 9 There is evidence suggesting that OSA may also be linked to an increased risk of VTE.…”

Section: Introductionmentioning

confidence: 99%

The Association between Obstructive Sleep Apnea and Venous Thromboembolism: A Bidirectional Two-Sample Mendelian Randomization Study

Huang,

Zheng,

Pang

et al. 2024

Thromb Haemost

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Background Despite previous observational studies linking obstructive sleep apnea (OSA) to venous thromboembolism (VTE), these findings remain controversial. This study aimed to explore the association between OSA and VTE, including pulmonary embolism (PE) and deep vein thrombosis (DVT), at a genetic level using a bidirectional two-sample Mendelian randomization (MR) analysis. Methods Utilizing summary-level data from large-scale genome-wide association studies (GWAS) in European individuals, we designed a bidirectional two-sample MR analysis to comprehensively assess the genetic association between OSA and VTE. The inverse variance weighting (IVW) was used as the primary method for MR analysis. In addition, MR-Egger, weighted median, and MR pleiotropy residual sum and outlier (MR-PRESSO) were used for complementary analyses. Furthermore, a series of sensitivity analyses were performed to ensure the validity and robustness of the results. Results The initial and validation MR analyses indicated that genetically predicted OSA had no effects on the risk of VTE (including PE and DVT). Likewise, the reverse MR analysis did not find substantial support for a significant association between VTE (including PE and DVT) and OSA. Supplementary MR methods and sensitivity analyses provided additional confirmation of the reliability of the MR results. Conclusion Our bidirectional two-sample MR analysis did not find genetic evidence supporting a significant association between OSA and VTE in either direction.

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“…Several therapeutic approaches have been applied to address CSA and OSA, but none of these pharmacologic interventions have been shown to significantly improve patients' prognoses for HF [6][7][8][9]. Due to its correlation with poorer left ventricular function and an advanced New York Heart Association (NYHA) class [10], CSA seems to be a significant indication of HF severity, despite OSA being considered an independent risk factor augmenting HF morbidity and death [11][12][13][14][15][16][17], while the benefits of non-invasive ventilation (NIV) for CSA therapy in HF are still debatable [18][19][20], as suggested by the findings of both SERVE-HF [21] and ADVENT-HF [22] randomized clinical trials. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) lower blood glucose levels inhibiting SGLT2 in the renal tubules; however, despite some intriguing hypotheses, the main mechanisms underlying its cardioprotective effects are largely unknown.…”

Section: Introductionmentioning

confidence: 99%

Effect of SGLT2-Inhibitors on Polygraphic Parameters in Elderly Patients Affected by Heart Failure, Type 2 Diabetes Mellitus, and Sleep Apnea

Armentaro,

Pelaia,

Condoleo

et al. 2024

Biomedicines

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Obstructive sleep apneas (OSAs) and central sleep apneas (CSAs) are the most common comorbidities in Heart Failure (HF) that are strongly associated with all-cause mortality. Several therapeutic approaches have been used to treat CSA and OSA, but none have been shown to significantly improve HF prognosis. Our study evaluated the effects of a 3-months treatment with sodium-glucose cotransporter type 2 inhibitor (SGLT2i) on polygraphic parameters in patients with sleep apnea (SA) and HF, across the spectrum of ejection fraction, not treated with continuous positive air pressure (CPAP). A group of 514 consecutive elderly outpatients with HF, type 2 diabetes mellitus (T2DM) and SA, eligible for treatment with SGLT2i, were included in the investigation before starting any CPAP therapy. The two groups were compared with the t-test and Mann–Whitney test for unpaired data when appropriate. Then, a simple logistic regression model was built using 50% reduction in AHI as the dependent variable and other variables as covariates. A multivariate stepwise logistic regression model was constructed using the variables that linked with the dependent variable to calculate the odds ratio (OR) for the independent predictors associated with the reduction of 50% in AHI. The treated group experienced significant improvements in polygraphic parameters between baseline values and follow-up with reduction in AHI (28.4 ± 12.9 e/h vs. 15.2 ± 6.5 e/h; p < 0.0001), ODI (15.4 ± 3.3 e/h vs. 11.1 ± 2.6 e/h; p < 0.0001), and TC90 (14.1 ± 4.2% vs. 8.2 ± 2.0%; p < 0.0001), while mean SpO2 improved (91. 3 ± 2.3 vs. 93.8 ± 2.5); p < 0.0001. These benefits were not seen in the untreated population. The use of SGLT2i in patients suffering from HF and mixed-type SA not on CPAP therapy significantly contributes to improving polygraphic parameters.

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A State-of-the-Art Review on Sleep Apnea Syndrome and Heart Failure

Cited by 5 publications

References 132 publications

The Role of Sleep in Cardiovascular Disease

The Role of Sleep in Cardiovascular Disease

The Association between Obstructive Sleep Apnea and Venous Thromboembolism: A Bidirectional Two-Sample Mendelian Randomization Study

Effect of SGLT2-Inhibitors on Polygraphic Parameters in Elderly Patients Affected by Heart Failure, Type 2 Diabetes Mellitus, and Sleep Apnea

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