Sleep Disordered Breathing in Heart Failure Patients with Reduced versus Preserved Ejection Fraction

Sekizuka, Hiromitsu; Osada, Naohiko; Miyake, Fumihiko

doi:10.1016/j.hlc.2012.08.006

Cited by 37 publications

(23 citation statements)

References 31 publications

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“…Studies to date in HFpEF patients generally assessed <200 patients, with the emphasis on describing prevalence and patient characteristics, rather than outcomes (95,108). Thus, future research is required to explore the impact of SDB on outcomes in HFpEF.…”

Section: Comorbidities In Hfref Versus Hfpef Patients: Prevalence Oumentioning

confidence: 99%

Noncardiac Comorbidities in Heart Failure With Reduced Versus Preserved Ejection Fraction

Mentz

Kelly

Lueder

et al. 2014

Journal of the American College of Cardiology

480

311

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Heart failure patients are classified by ejection fraction (EF) into distinct groups: heart failure with preserved EF (HFpEF) or heart failure with reduced EF (HFrEF). Although patients with heart failure commonly have multiple comorbidities that complicate management and may adversely affect outcomes, their role in the HFpEF and HFrEF groups is not well-characterized. This review summarizes the role of noncardiac comorbidities in patients with HFpEF versus HFrEF, emphasizing prevalence, underlying pathophysiologic mechanisms, and outcomes. Pulmonary disease, diabetes mellitus, anemia, and obesity tend to be more prevalent in HFpEF patients, but renal disease and sleep-disordered breathing burdens are similar. These comorbidities similarly increase morbidity and mortality risk in HFpEF and HFrEF patients. Common pathophysiologic mechanisms include systemic and endomyocardial inflammation with fibrosis. We also discuss implications for clinical care and future HF clinical trial design. The basis for this review was discussions between scientists, clinical trialists, and regulatory representatives at the 10th Global CardioVascular Clinical Trialists Forum.

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Section: Comorbidities In Hfref Versus Hfpef Patients: Prevalence Oumentioning

confidence: 99%

Noncardiac Comorbidities in Heart Failure With Reduced Versus Preserved Ejection Fraction

Mentz

Kelly

Lueder

et al. 2014

Journal of the American College of Cardiology

480

311

View full text Add to dashboard Cite

show abstract

“…The prevalence of OSA ranges from 40% to 62% in obese patients with HFpEF compared to 10% in nonobese HFpEF patients 249, 250, 251. Independently from hypertension and obesity, OSA impairs LV diastolic function, begets LVH, and thus may hasten HFpEF progression 126, 127, 252, 253, 254, 255, 256, 257, 258.…”

Section: Comorbid Conditionsmentioning

confidence: 99%

Clinical Phenotypes in Heart Failure With Preserved Ejection Fraction

Samson

Jaiswal

Ennezat

et al. 2016

JAHA

109

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“…There is a high prevalence of sleep disordered breathing, which includes OSA and central sleep apnea in patients with HFpEF [109, 110]. Often, poorly controlled HF and congestion are the underlying causes, and sleep-disordered breathing may improve with HF treatment.…”

Section: Non-pharmacological Treatments For Htn In Hfpefmentioning

confidence: 99%

Current Perspectives on Systemic Hypertension in Heart Failure with Preserved Ejection Fraction

et al. 2017

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Heart failure with preserved ejection fraction (HFpEF) is a prevalent but incompletely understood syndrome. Traditional models of HFpEF pathophysiology revolve around systemic HTN and other causes of increased left ventricular afterload leading to left ventricular hypertrophy (LVH) and diastolic dysfunction. However, emerging models attribute the development of HFpEF to systemic proinflammatory changes secondary to common comorbidities which include HTN. Alterations in passive ventricular stiffness, ventricular-arterial coupling, peripheral microvascular function, systolic reserve, and chronotropic response occur. As a result, HFpEF is heterogeneous in nature, making it difficult to prescribe uniform therapies to all patients. Nonetheless, treating systemic HTN remains a cornerstone of HFpEF management. Antihypertensive therapies have been linked to LVH regression and improvement in diastolic dysfunction. However, to date, no therapies have definitive mortality benefit in HFpEF. Non-pharmacologic management for HTN, including dietary modification, exercise, and treating sleep disordered breathing, may provide some morbidity benefit in the HFpEF population. Future research is need to identify effective treatments, perhaps in more specific subgroups, and focus may need to shift from reducing mortality to improving exercise capacity and symptoms. Tailoring antihypertensive therapies to specific phenotypes of HFpEF may be an important component of this strategy.

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Sleep Disordered Breathing in Heart Failure Patients with Reduced versus Preserved Ejection Fraction

Cited by 37 publications

References 31 publications

Noncardiac Comorbidities in Heart Failure With Reduced Versus Preserved Ejection Fraction

Noncardiac Comorbidities in Heart Failure With Reduced Versus Preserved Ejection Fraction

Clinical Phenotypes in Heart Failure With Preserved Ejection Fraction

Current Perspectives on Systemic Hypertension in Heart Failure with Preserved Ejection Fraction

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