The comorbidity burden and disease phenotype in pre-capillary pulmonary hypertension: The contributing role of obstructive sleep apnea

Duan, Anqi; Huang, Zhihua; Hu, Meixi; Zhao, Zhihui; Zhao, Qing; Jin, Qi; Liu, Yan; Zhang, Yi; Li, Xin; An, Chansik; Luo, Qin; Liu, Zhihong

doi:10.1016/j.sleep.2022.10.029

Cited by 4 publications

(2 citation statements)

References 35 publications

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“…Numerous observational studies and a few longitudinal research studies found that cardiovascular events are the most prevalent complications in OSA (Appleton et al, 2018;Duan et al, 2023;Ga c et al, 2022;Pinto et al, 2016;Testelmans et al, 2022). Impaired…”

Section: Comorbid Phenotypesmentioning

confidence: 99%

“…In this review, comorbid OSA phenotypes are referred to as OSA with existing complications. Numerous observational studies and a few longitudinal research studies found that cardiovascular events are the most prevalent complications in OSA (Appleton et al, 2018; Duan et al, 2023; Gać et al, 2022; Pinto et al, 2016; Testelmans et al, 2022). Impaired HRV is related to the risk and incidence of adverse cardiovascular outcomes.…”

Section: Obstructive Sleep Apnea Phenotypingmentioning

confidence: 99%

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Obstructive sleep apnea heterogeneity and autonomic function: a role for heart rate variability in therapy selection and efficacy monitoring

Qin,

Fietze,

Mazzotti

et al. 2023

Journal of Sleep Research

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SUMMARYObstructive sleep apnea is a highly prevalent sleep‐related breathing disorder, resulting in a disturbed breathing pattern, changes in blood gases, abnormal autonomic regulation, metabolic fluctuation, poor neurocognitive performance, and increased cardiovascular risk. With broad inter‐individual differences recognised in risk factors, clinical symptoms, gene expression, physiological characteristics, and health outcomes, various obstructive sleep apnea subtypes have been identified. Therapeutic efficacy and its impact on outcomes, particularly for cardiovascular consequences, may also vary depending on these features in obstructive sleep apnea. A number of interventions such as positive airway pressure therapies, oral appliance, surgical treatment, and pharmaceutical options are available in clinical practice. Selecting an effective obstructive sleep apnea treatment and therapy is a challenging medical decision due to obstructive sleep apnea heterogeneity and numerous treatment modalities. Thus, an objective marker for clinical evaluation is warranted to estimate the treatment response in patients with obstructive sleep apnea. Currently, while the Apnea–Hypopnea Index is used for severity assessment of obstructive sleep apnea and still considered a major guide to diagnosis and managements of obstructive sleep apnea, the Apnea–Hypopnea Index is not a robust marker of symptoms, function, or outcome improvement. Abnormal cardiac autonomic modulation can provide additional insight to better understand obstructive sleep apnea phenotyping. Heart rate variability is a reliable neurocardiac tool to assess altered autonomic function and can also provide cardiovascular information in obstructive sleep apnea. Beyond the Apnea–Hypopnea Index, this review aims to discuss the role of heart rate variability as an indicator and predictor of therapeutic efficacy to different modalities in order to optimise tailored treatment for obstructive sleep apnea.

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Section: Comorbid Phenotypesmentioning

confidence: 99%

Section: Obstructive Sleep Apnea Phenotypingmentioning

confidence: 99%

Obstructive sleep apnea heterogeneity and autonomic function: a role for heart rate variability in therapy selection and efficacy monitoring

Qin,

Fietze,

Mazzotti

et al. 2023

Journal of Sleep Research

View full text Add to dashboard Cite

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Sleep-disordered breathing patterns and prognosis in pulmonary arterial hypertension: A cluster analysis of nocturnal cardiorespiratory signals

Huang,

Duan,

Zhao

et al. 2024

Sleep Medicine

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Sleep Disordered Breathing and Exercise in Pulmonary Hypertension

Singh,

Mullin

2024

Advances in Pulmonary Hypertension

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Exercise intolerance is a common feature of many cardiopulmonary diseases including pulmonary hypertension (PH) and sleep disordered breathing (SDB), which includes obstructive sleep apnea and obesity hypoventilation syndrome. Physiologic abnormalities in both PH and SDB can drive exercise intolerance, and biological mechanisms overlap among the conditions including systemic inflammation, oxidative stress, metabolic dysfunction, and endothelial dysfunction. Despite this understanding, evidence establishing clear causal relationships among PH, SDB, and exercise intolerance is lacking. Data show that treatment of SDB may improve exercise capacity, and exercise training likely improves SDB, although these relationships specifically in PH remain understudied. In this manuscript, we summarize existing data of mechanisms and clinical observations in PH, SDB and exercise and identify gaps and opportunities for future investigation.

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The comorbidity burden and disease phenotype in pre-capillary pulmonary hypertension: The contributing role of obstructive sleep apnea

Cited by 4 publications

References 35 publications

Obstructive sleep apnea heterogeneity and autonomic function: a role for heart rate variability in therapy selection and efficacy monitoring

Obstructive sleep apnea heterogeneity and autonomic function: a role for heart rate variability in therapy selection and efficacy monitoring

Sleep-disordered breathing patterns and prognosis in pulmonary arterial hypertension: A cluster analysis of nocturnal cardiorespiratory signals

Sleep Disordered Breathing and Exercise in Pulmonary Hypertension

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