Congestive heart failure and obstructive sleep apnea: Difference between revisions

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* Predictors of risk [[OSA]] and [[CSA]] in [[HFrEF]] are [[atrial fibrillation]], [[ventricular arrhythmias]], lower [[LV ejection fraction]] ([[LVEF]], and higher levels of [[serum]] [[brain natriuretic peptide]] ([[BNP]]), [[endothelin-1]], and [[urinary]] [[norepinephrine]].<ref name="pmid19398074">{{cite journal |vauthors=Yumino D, Wang H, Floras JS, Newton GE, Mak S, Ruttanaumpawan P, Parker JD, Bradley TD |title=Prevalence and physiological predictors of sleep apnea in patients with heart failure and systolic dysfunction |journal=J Card Fail |volume=15 |issue=4 |pages=279–85 |date=May 2009 |pmid=19398074 |doi=10.1016/j.cardfail.2008.11.015 |url=}}</ref><ref name="pmid17030014">{{cite journal |vauthors=Vazir A, Hastings PC, Dayer M, McIntyre HF, Henein MY, Poole-Wilson PA, Cowie MR, Morrell MJ, Simonds AK |title=A high prevalence of sleep disordered breathing in men with mild symptomatic chronic heart failure due to left ventricular systolic dysfunction |journal=Eur J Heart Fail |volume=9 |issue=3 |pages=243–50 |date=March 2007 |pmid=17030014 |doi=10.1016/j.ejheart.2006.08.001 |url=}}</ref><ref name="pmid16321661">{{cite journal |vauthors=Javaheri S |title=Sleep disorders in systolic heart failure: a prospective study of 100 male patients. The final report |journal=Int J Cardiol |volume=106 |issue=1 |pages=21–8 |date=January 2006 |pmid=16321661 |doi=10.1016/j.ijcard.2004.12.068 |url=}}</ref><ref name="pmid17030014">{{cite journal |vauthors=Vazir A, Hastings PC, Dayer M, McIntyre HF, Henein MY, Poole-Wilson PA, Cowie MR, Morrell MJ, Simonds AK |title=A high prevalence of sleep disordered breathing in men with mild symptomatic chronic heart failure due to left ventricular systolic dysfunction |journal=Eur J Heart Fail |volume=9 |issue=3 |pages=243–50 |date=March 2007 |pmid=17030014 |doi=10.1016/j.ejheart.2006.08.001 |url=}}</ref>
* Predictors of risk [[OSA]] and [[CSA]] in [[HFrEF]] are [[atrial fibrillation]], [[ventricular arrhythmias]], lower [[LV ejection fraction]] ([[LVEF]], and higher levels of [[serum]] [[brain natriuretic peptide]] ([[BNP]]), [[endothelin-1]], and [[urinary]] [[norepinephrine]].<ref name="pmid19398074">{{cite journal |vauthors=Yumino D, Wang H, Floras JS, Newton GE, Mak S, Ruttanaumpawan P, Parker JD, Bradley TD |title=Prevalence and physiological predictors of sleep apnea in patients with heart failure and systolic dysfunction |journal=J Card Fail |volume=15 |issue=4 |pages=279–85 |date=May 2009 |pmid=19398074 |doi=10.1016/j.cardfail.2008.11.015 |url=}}</ref><ref name="pmid17030014">{{cite journal |vauthors=Vazir A, Hastings PC, Dayer M, McIntyre HF, Henein MY, Poole-Wilson PA, Cowie MR, Morrell MJ, Simonds AK |title=A high prevalence of sleep disordered breathing in men with mild symptomatic chronic heart failure due to left ventricular systolic dysfunction |journal=Eur J Heart Fail |volume=9 |issue=3 |pages=243–50 |date=March 2007 |pmid=17030014 |doi=10.1016/j.ejheart.2006.08.001 |url=}}</ref><ref name="pmid16321661">{{cite journal |vauthors=Javaheri S |title=Sleep disorders in systolic heart failure: a prospective study of 100 male patients. The final report |journal=Int J Cardiol |volume=106 |issue=1 |pages=21–8 |date=January 2006 |pmid=16321661 |doi=10.1016/j.ijcard.2004.12.068 |url=}}</ref><ref name="pmid17030014">{{cite journal |vauthors=Vazir A, Hastings PC, Dayer M, McIntyre HF, Henein MY, Poole-Wilson PA, Cowie MR, Morrell MJ, Simonds AK |title=A high prevalence of sleep disordered breathing in men with mild symptomatic chronic heart failure due to left ventricular systolic dysfunction |journal=Eur J Heart Fail |volume=9 |issue=3 |pages=243–50 |date=March 2007 |pmid=17030014 |doi=10.1016/j.ejheart.2006.08.001 |url=}}</ref>


==Effect of [[CPAP]] in [[HFrEF]]==
==Effect of [[CPAP]] in [[patients]] with [[HFrEF]]==
* Use of nocturnal [[continuous positive airway pressure]] ([[CPAP]]) in [[OSA]] and [[HFrEF]] was associated with reduced central [[sympathetic]] [[vasoconstrictor]] outflow and improve [[vagal]] modulation of the [[heart]] by increasing high-frequency [[heart rate variability]].<ref name="pmid15963401">{{cite journal |vauthors=Usui K, Bradley TD, Spaak J, Ryan CM, Kubo T, Kaneko Y, Floras JS |title=Inhibition of awake sympathetic nerve activity of heart failure patients with obstructive sleep apnea by nocturnal continuous positive airway pressure |journal=J Am Coll Cardiol |volume=45 |issue=12 |pages=2008–11 |date=June 2005 |pmid=15963401 |doi=10.1016/j.jacc.2004.12.080 |url=}}</ref><ref name="pmid17824846">{{cite journal |vauthors=Gilman MP, Floras JS, Usui K, Kaneko Y, Leung RS, Bradley TD |title=Continuous positive airway pressure increases heart rate variability in heart failure patients with obstructive sleep apnoea |journal=Clin Sci (Lond) |volume=114 |issue=3 |pages=243–9 |date=February 2008 |pmid=17824846 |doi=10.1042/CS20070172 |url=}}</ref>
* Use of nocturnal [[continuous positive airway pressure]] ([[CPAP]]) in [[OSA]] and [[HFrEF]] was associated with reduced central [[sympathetic]] [[vasoconstrictor]] outflow and improve [[vagal]] modulation of the [[heart]] by increasing high-frequency [[heart rate variability]].<ref name="pmid15963401">{{cite journal |vauthors=Usui K, Bradley TD, Spaak J, Ryan CM, Kubo T, Kaneko Y, Floras JS |title=Inhibition of awake sympathetic nerve activity of heart failure patients with obstructive sleep apnea by nocturnal continuous positive airway pressure |journal=J Am Coll Cardiol |volume=45 |issue=12 |pages=2008–11 |date=June 2005 |pmid=15963401 |doi=10.1016/j.jacc.2004.12.080 |url=}}</ref><ref name="pmid17824846">{{cite journal |vauthors=Gilman MP, Floras JS, Usui K, Kaneko Y, Leung RS, Bradley TD |title=Continuous positive airway pressure increases heart rate variability in heart failure patients with obstructive sleep apnoea |journal=Clin Sci (Lond) |volume=114 |issue=3 |pages=243–9 |date=February 2008 |pmid=17824846 |doi=10.1042/CS20070172 |url=}}</ref>
* Other advantages of use of [[CPAP]] in [[HFrEF]] include reduction in [[apnea-hypopnea index]], number of [[arousal]] per night, and daytime [[systolic blood pressure]] and [[heart rate]] combined with decrease in [[left ventricular]] end-systolic diameter and an 8.8% absolute increase in [[LVEF]].<ref name="pmid12660387">{{cite journal |vauthors=Kaneko Y, Floras JS, Usui K, Plante J, Tkacova R, Kubo T, Ando S, Bradley TD |title=Cardiovascular effects of continuous positive airway pressure in patients with heart failure and obstructive sleep apnea |journal=N Engl J Med |volume=348 |issue=13 |pages=1233–41 |date=March 2003 |pmid=12660387 |doi=10.1056/NEJMoa022479 |url=}}</ref><ref name="pmid14597482">{{cite journal |vauthors=Mansfield DR, Gollogly NC, Kaye DM, Richardson M, Bergin P, Naughton MT |title=Controlled trial of continuous positive airway pressure in obstructive sleep apnea and heart failure |journal=Am J Respir Crit Care Med |volume=169 |issue=3 |pages=361–6 |date=February 2004 |pmid=14597482 |doi=10.1164/rccm.200306-752OC |url=}}</ref>
* Other advantages of use of [[CPAP]] in [[HFrEF]] include reduction in [[apnea-hypopnea index]], number of [[arousal]] per night, and daytime [[systolic blood pressure]] and [[heart rate]] combined with decrease in [[left ventricular]] end-systolic diameter and an 8.8% absolute increase in [[LVEF]].<ref name="pmid12660387">{{cite journal |vauthors=Kaneko Y, Floras JS, Usui K, Plante J, Tkacova R, Kubo T, Ando S, Bradley TD |title=Cardiovascular effects of continuous positive airway pressure in patients with heart failure and obstructive sleep apnea |journal=N Engl J Med |volume=348 |issue=13 |pages=1233–41 |date=March 2003 |pmid=12660387 |doi=10.1056/NEJMoa022479 |url=}}</ref><ref name="pmid14597482">{{cite journal |vauthors=Mansfield DR, Gollogly NC, Kaye DM, Richardson M, Bergin P, Naughton MT |title=Controlled trial of continuous positive airway pressure in obstructive sleep apnea and heart failure |journal=Am J Respir Crit Care Med |volume=169 |issue=3 |pages=361–6 |date=February 2004 |pmid=14597482 |doi=10.1164/rccm.200306-752OC |url=}}</ref>
* Use of [[CPAP]] was associated with improvement in [[quality of life]].
* Use of [[CPAP]] was associated with improvement in [[quality of life]].
==Effect of [[CPAP ]] in [[patients]] with [[HFpEF]]==
*[[Diastolic]] function improved in [[patients]] after 12 weeks of [[CPAP]] therapy among [[patients]] with [[OSA]] and [[diastolic dysfunction]] without evidence of [[HFpEF]].


==References==
==References==

Revision as of 18:13, 26 March 2022



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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Obstructive sleep apnea is a sleep-related breathing disorder with effects on cardiovascular system by increasing the risk of hypertension, coronary artery disease, cardiac arrhythmias, sudden cardiac death, and heart failure. Obstructive sleep apnea contributes to the development and progression of HF. Hypoxia caused activation of inflammatory pathway leading to endothelial damage, atherogenesis, and heart failure. Activate profibrotic transforming growth factor-β during inflammatory process may cause increased deposition of extracellular matrix and consequent myocardial fibrosis and worsening LV diastolic function.

Sleep apnea in heart failure disease

Pathophysiology

Effect of CPAP in patients with HFrEF

Effect of CPAP in patients with HFpEF

References

  1. Yu AY, Shimoda LA, Iyer NV, Huso DL, Sun X, McWilliams R, Beaty T, Sham JS, Wiener CM, Sylvester JT, Semenza GL (March 1999). "Impaired physiological responses to chronic hypoxia in mice partially deficient for hypoxia-inducible factor 1alpha". J Clin Invest. 103 (5): 691–6. doi:10.1172/JCI5912. PMC 408131. PMID 10074486.
  2. 2.0 2.1 Yumino D, Wang H, Floras JS, Newton GE, Mak S, Ruttanaumpawan P, Parker JD, Bradley TD (May 2009). "Prevalence and physiological predictors of sleep apnea in patients with heart failure and systolic dysfunction". J Card Fail. 15 (4): 279–85. doi:10.1016/j.cardfail.2008.11.015. PMID 19398074.
  3. 3.0 3.1 Vazir A, Hastings PC, Dayer M, McIntyre HF, Henein MY, Poole-Wilson PA, Cowie MR, Morrell MJ, Simonds AK (March 2007). "A high prevalence of sleep disordered breathing in men with mild symptomatic chronic heart failure due to left ventricular systolic dysfunction". Eur J Heart Fail. 9 (3): 243–50. doi:10.1016/j.ejheart.2006.08.001. PMID 17030014.
  4. Javaheri S (January 2006). "Sleep disorders in systolic heart failure: a prospective study of 100 male patients. The final report". Int J Cardiol. 106 (1): 21–8. doi:10.1016/j.ijcard.2004.12.068. PMID 16321661.
  5. Usui K, Bradley TD, Spaak J, Ryan CM, Kubo T, Kaneko Y, Floras JS (June 2005). "Inhibition of awake sympathetic nerve activity of heart failure patients with obstructive sleep apnea by nocturnal continuous positive airway pressure". J Am Coll Cardiol. 45 (12): 2008–11. doi:10.1016/j.jacc.2004.12.080. PMID 15963401.
  6. Gilman MP, Floras JS, Usui K, Kaneko Y, Leung RS, Bradley TD (February 2008). "Continuous positive airway pressure increases heart rate variability in heart failure patients with obstructive sleep apnoea". Clin Sci (Lond). 114 (3): 243–9. doi:10.1042/CS20070172. PMID 17824846.
  7. Kaneko Y, Floras JS, Usui K, Plante J, Tkacova R, Kubo T, Ando S, Bradley TD (March 2003). "Cardiovascular effects of continuous positive airway pressure in patients with heart failure and obstructive sleep apnea". N Engl J Med. 348 (13): 1233–41. doi:10.1056/NEJMoa022479. PMID 12660387.
  8. Mansfield DR, Gollogly NC, Kaye DM, Richardson M, Bergin P, Naughton MT (February 2004). "Controlled trial of continuous positive airway pressure in obstructive sleep apnea and heart failure". Am J Respir Crit Care Med. 169 (3): 361–6. doi:10.1164/rccm.200306-752OC. PMID 14597482.

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