Sleep-Disordered Breathing in Patients with Heart Failure

Mentz, Robert J.; Fiuzat, Mona

doi:10.1016/j.hfc.2013.10.001

Cited by 15 publications

(12 citation statements)

References 67 publications

(74 reference statements)

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“…However, the lack of excessive daytime sleepiness, a characteristic of OSA patients from the overall population referred to sleep laboratories may explain the low awareness of OSA in patients with cardiovascular disease. 21 This finding is in line with other populations with cardiovascular diseases, including heart failure 22 and hypertrophic cardiomyopathy. 23 The low prevalence of central sleep apnea in our sample is in contrast with a previous study that evaluated sleep disorders in patients with heart failure (LVEF < 45%), including CD.…”

Section: Discussionsupporting

confidence: 83%

“…Intermittent hypoxia may also influence cardiac contractility, directly or indirectly, thereby reducing cardiac output. 22 OSA induces hypoxia, hypercapnia and sleep arousals, thus promoting an increase in sympathetic activity and hence, in blood pressure. 31 Long-term exposure to high sympathetic nerve activity can induce hypertrophy and apoptosis of the cardiac myocytes 32 and thereby cause left ventricular dysfunction.…”

Section: Discussionmentioning

confidence: 99%

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Obstructive Sleep Apnea is Common and Associated with Heart Remodeling in Patients with Chagas Disease

Medeiros¹,

Secundo²,

Silveira³

et al. 2018

Arquivos Brasileiros De Cardiologia

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BackgroundChagas Disease (CD) is an important cause of morbimortality due to heart failure and malignant arrhythmias worldwide, especially in Latin America.ObjectiveTo investigate the association of obstructive sleep apnea (OSA) with heart remodeling and cardiac arrhythmias in patients CD.MethodsConsecutive patients with CD, aged between 30 to 65 years old were enrolled. Participants underwent clinical evaluation, sleep study, 24-hour Holter monitoring, echocardiogram and ambulatory blood pressure monitoring.ResultsWe evaluated 135 patients [age: 56 (45-62) years; 30% men; BMI: 26 ± 4 kg/m2, Chagas cardiomyopathy: 70%]. Moderate to severe OSA (apnea-hypopnea index, AHI, ≥ 15 events/h) was present in 21% of the patients. OSA was not associated with arrhythmias in this population. As compared to patients with mild or no OSA, patients with moderate to severe OSA had higher frequency of hypertension (79% vs. 72% vs. 44%, p < 0.01) higher nocturnal systolic blood pressure: 119 ± 17 vs. 113 ± 13 vs. 110 ± 11 mmHg, p = 0.01; larger left atrial diameter [37 (33-42) vs. 35 (33-39) vs. 33 (30-36) mm, p < 0.01]; and a greater proportion of left ventricular dysfunction [LVEF < 50% (39% vs. 28% vs. 11%), p < 0.01], respectively. Predictor of left atrial dimension was Log10 (AHI) (β = 3.86, 95% CI: 1.91 to 5.81; p < 0.01). Predictors of ventricular dysfunction were AHI > 15 events/h (OR = 3.61, 95% CI: 1.31 - 9.98; p = 0.01), systolic blood pressure (OR = 1.06, 95% CI: 1.02 - 1.10; p < 0.01) and male gender (OR = 3.24, 95% CI: 1.31 - 8.01; p = 0.01).ConclusionsOSA is independently associated with atrial and ventricular remodeling in patients with CD.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Obstructive Sleep Apnea is Common and Associated with Heart Remodeling in Patients with Chagas Disease

Medeiros¹,

Secundo²,

Silveira³

et al. 2018

Arquivos Brasileiros De Cardiologia

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“…chronic obstructive pulmonary disease, sleep disordered breathing, etc.) is high and may confound interpretation (20–22). Third, dyspnea may be elicited in patients who are asymptomatic at rest by performing provocative maneuvers (e.g.…”

Section: Discussionmentioning

confidence: 99%

Body Weight Change During and After Hospitalization for Acute Heart Failure: Patient Characteristics, Markers of Congestion, and Outcomes

Ambrosy

Cerbin

Armstrong

et al. 2017

JACC: Heart Failure

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Background Body weight changes during and after hospitalization for acute heart failure (AHF) and the relationships with outcomes have not been well-characterized. Methods A post-hoc analysis was performed of the ASCEND-HF trial, which enrolled patients admitted for AHF regardless of ejection fraction. In-hospital body weight change was defined as the difference between baseline and discharge/day 10, while post-discharge body weight change was defined as the difference between discharge/day 10 and day 30. Spearman rank correlations of weight change, urine output (UOP), and dyspnea relief as assessed by a 7-point Likert scale are described. Logistic and Cox proportional hazards regression was used to evaluate the relationship between weight change and outcomes. Results Study participants with complete body weight data (n = 4,172) had a mean age of 65±14 years and 66% were male. Ischemic heart disease was reported in 60% of patients and the average ejection fraction was 30±13%. The median change in body weight was −1.0 kg (interquartile range [IQR]: −2.1, 0.0) at 24 hr and −2.3 kg (IQR: −5.0, −0.7) by discharge/day 10. At hour 24, there was a weak correlation between change in body weight and UOP (r = −0.381) and minimal correlation between body weight change and dyspnea relief (r = −0.096). After risk adjustment, increasing body weight during hospitalization was associated with a 16% increase per kg in the likelihood of 30-day mortality or HF readmission for patients showing weight loss ≤1 kg or weight gain during hospitalization (Odds Ratio per kg increase 1.16, 95% Confidence Interval [CI] 1.09–1.27; p<0.001). Among the subset of patients experiencing > 1 kg increase in body weight post-discharge, increasing body weight was associated with higher risk of 180-day mortality (Hazard Ratio per kg increase 1.16, 95% CI 1.09–1.23; p<0.001). Conclusion A substantial number of patients experienced minimal weight loss or frank weight gain in the context of an AHF trial, and increasing body weight in this subset of patients was independently associated with a worse post-discharge prognosis.

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“…Расстройства дыхания во сне по данным разных авторов встречаются в 50-80% случаев при сердечной недостаточности, при этом синдром обструктивного апноэ во время сна (СОАС) занимает одно из ведущих мест, его распространённость в данной когорте составляет около 18%, что значительно превышает общепопуляционные показатели [3,4].…”

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Obstructive Sleep Apnea Syndrome in Congestive Heart Failure: Cardiologist Perspective

Медведева¹,

Korostovtseva²,

Сазонова³

et al. 2018

Russ J Cardiol

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В обзоре представлены данные о нарушениях дыхания во сне у пациентов с хронической сердечной недостаточностью с акцентом на синдром обструктивного апноэ во время сна (СОАС). Обсуждаются аспекты распространённости, патогенеза, диагностики и особенностей терапии СОАС при сниженной и сохранённой фракции выброса. Представлены собственные результаты по оценке нарушений дыхания во сне у пациентов с тяжёлой систолической дисфункцией. Обоснована необходимость персонализированного диагностического и терапевтического подхода к пациентам с синдромом обструктивного апноэ сна, который является не только фактором риска развития сердечной недостаточности, но и коморбидным состоянием на разных этапах сердечно-сосудистого континуума.

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Sleep-Disordered Breathing in Patients with Heart Failure

Cited by 15 publications

References 67 publications

Obstructive Sleep Apnea is Common and Associated with Heart Remodeling in Patients with Chagas Disease

Obstructive Sleep Apnea is Common and Associated with Heart Remodeling in Patients with Chagas Disease

Body Weight Change During and After Hospitalization for Acute Heart Failure: Patient Characteristics, Markers of Congestion, and Outcomes

Obstructive Sleep Apnea Syndrome in Congestive Heart Failure: Cardiologist Perspective

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