Obstructive Sleep Apnea and Circulating Potassium Channel Levels

Ji, Ning; Zhou, Anyu; Prasad, Bharati; Zhou, Li; Doumit, Jimmy; Shi, Guitao; Imran, Hafiz; Kaseer, Bahaa; Millman, Richard P.; Dudley, Samuel C.

doi:10.1016/s0735-1097(16)30771-9

Cited by 2 publications

(3 citation statements)

References 24 publications

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“…A recent study showed that CPAP treatment improved gene expression of circulating potassium channels in patients with moderate OSA but not in those with severe OSA. 71 Downregulation of potassium channels in patients with OSA may explain prolonged QT interval and increased risk of ventricular arrhythmia and sudden cardiac death. 71 Hence, CPAP treatment may not reverse long-term structural remodeling which triggers arrhythmia; however, it may decrease further progression of such events.…”

Section: General Discussion and Future Directionsmentioning

confidence: 99%

“…71 Downregulation of potassium channels in patients with OSA may explain prolonged QT interval and increased risk of ventricular arrhythmia and sudden cardiac death. 71 Hence, CPAP treatment may not reverse long-term structural remodeling which triggers arrhythmia; however, it may decrease further progression of such events. Therefore, treatment of OSA with CPAP therapy should be considered as an adjunct to the medical therapy for arrhythmia and/or other related conditions and not as a sole treatment.…”

Section: General Discussion and Future Directionsmentioning

confidence: 99%

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Efficacy of Continuous Positive Airway Pressure Treatment in Patients with Cardiac Arrhythmia and Obstructive Sleep Apnea: What is the Evidence?

Abumuamar

Mollayeva

Sandor

et al. 2017

Clinical Medicine Insights: Therapeutics

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Numerous studies have been conducted in the past few decades on obstructive sleep apnea (OSA) as an independent risk factor for the development and progression of cardiac arrhythmia. Treatment with continuous positive airway pressure (CPAP) therapy lowers blood pressure, improves ejection fraction in patients with heart failure, and decreases the need of revascularization procedures in patients with coronary artery disease. However, there has been little published discussion regarding the effect of CPAP treatment on cardiac arrhythmia in patients with OSA. We aimed to summarize scientific evidence regarding the utility of CPAP treatment in managing the recurrence and severity of different types of cardiac arrhythmia. We retrieved articles published in English before December 2016, through database search of PubMed, CENTRAL, and Embase. All peer-reviewed experimental, comparative, and other observational studies focused on adults were considered eligible. Several studies documented positive changes in arrhythmia frequency and severity with CPAP application, irrespective of type of arrhythmia, study methodology, or setting. However, the available evidence on the impact of CPAP treatment on the frequency and severity of cardiac arrhythmia is limited by heterogeneity of data. The duration of CPAP application, compliance with treatment, and baseline severity of OSA and cardiac pathology are important confounding factors that influence the effect of CPAP treatment. We emphasize the need for agreement on a core set of relevant predictors of the magnitude of the effect. Future research should carefully address these factors and their influence on the potential therapeutic ability of CPAP treatment to improve cardiac outcomes and reduce the risks of adverse cardiac and noncardiac effects associated with untreated OSA.

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Section: General Discussion and Future Directionsmentioning

confidence: 99%

Section: General Discussion and Future Directionsmentioning

confidence: 99%

Efficacy of Continuous Positive Airway Pressure Treatment in Patients with Cardiac Arrhythmia and Obstructive Sleep Apnea: What is the Evidence?

Abumuamar

Mollayeva

Sandor

et al. 2017

Clinical Medicine Insights: Therapeutics

View full text Add to dashboard Cite

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“…The activity of hERG1 potassium channels, which contributes to the outward K + currents and underlies the long QT syndrome when mutated, was found to be significantly inhibited during mild oxidative stress [35] , as is the transient outward potassium current [36] . The high sensitivity and complex interplay of different ion channels under increased oxidative stress explains the electrocardiographic QT c and T peak -T end interval prolongation under intermittent hypoxia, reflecting prolonged repolarization and increased dispersion of repolarization, leading to increased reentry risk [37] , [38] , [39] , [40] .…”

Section: The Hypothesismentioning

confidence: 99%

COVID-19: Electrophysiological mechanisms underlying sudden cardiac death during exercise with facemasks

Lee¹,

Liu

et al. 2020

Medical Hypotheses

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The mandatory use of facemasks is a public health measure implemented by various countries in response to the novel coronavirus disease 19 (COVID-19) pandemic. However, there have been case reports of sudden cardiac death (SCD) with the wearing of facemasks during exercise. In this paper, we hypothesize that exercise with facemasks may increase the risk of ventricular tachycardia/ventricular fibrillation (VT/VF) leading to SCD via the development of acute and/or intermittent hypoxia and hypercapnia. We discuss the potential underlying mechanisms including increases in adrenergic stimulation and oxidative stress leading to electrophysiological abnormalities that promote arrhythmias via non-reentrant and reentrant mechanisms. Given the interplay of multiple variables contributing to the increased arrhythmic risk, we advise avoidance of a facemask during high intensity exercise, or if wearing of a mask is mandatory, exercise intensity should remain low to avoid precipitation of lethal arrhythmias. However, we cannot exclude the possibility of an arrhythmic substrate even with low intensity exercise especially in those with established chronic cardiovascular disease in whom baseline electrophysiological abnormalities may be found.

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Obstructive Sleep Apnea and Circulating Potassium Channel Levels

Cited by 2 publications

References 24 publications

Efficacy of Continuous Positive Airway Pressure Treatment in Patients with Cardiac Arrhythmia and Obstructive Sleep Apnea: What is the Evidence?

Efficacy of Continuous Positive Airway Pressure Treatment in Patients with Cardiac Arrhythmia and Obstructive Sleep Apnea: What is the Evidence?

COVID-19: Electrophysiological mechanisms underlying sudden cardiac death during exercise with facemasks

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